Medicaid provides essential healthcare coverage for millions of Americans, but eligibility often depends on income and assets. Understanding the income limits and asset tests can be confusing. This guide breaks down how much you can earn and still qualify for Medicaid, focusing on key factors like family size, disability status, and specific Medicaid programs.
Medicaid Program Options
Medicaid offers various programs to serve diverse populations. Individuals who are aged, blind, or disabled may be eligible for:
- Traditional Medicaid: This is the standard Medicaid program.
- Hoosier Care Connect: This program provides managed care services.
Key Eligibility Factors
Several factors determine Medicaid eligibility, including:
- Age: Most Medicaid programs serve individuals of all ages.
- Disability Status: If you are disabled, your disability must meet the Social Security Administration’s definition.
- Income and Assets: Medicaid sets limits on both income and assets to determine eligibility.
Income Limits Based on Family Size
Your family size significantly impacts the income limit for Medicaid eligibility. The following table illustrates the income limits per month based on family size, effective March 1, 2025:
| Family Size | Income Limit (Per Month) | Additional Details |
|---|---|---|
| 1 | $1,304.17 | Family size is based on the tax household. If you do not file taxes, the household includes the child(ren), the child(ren)’s parent(s) (biological, adopted, and step), and the child(ren)’s sibling(s) (biological, adopted, and step). These income standards are effective March 1, 2025. |
| 2 | $1,762.50 | |
| 3 | $2,220.83 | |
| 4 | $2,679.17 | |
| 5 | $3,137.50 |
It’s important to note that family size is determined by your tax household. If you don’t file taxes, the household includes children, their biological, adopted, or step-parents, and their biological, adopted, or step-siblings.
Special Cases for Income Limits
Certain situations allow for higher income limits under Medicaid:
- Institutionalized or Waiver Services: Disabled individuals who are institutionalized or eligible for Home and Community-Based Waiver services may qualify with monthly income of up to $2,901. This income standard is based on the individual only, without considering the income of a spouse or other household members. However, depending on their countable income, these individuals may be responsible for paying a monthly patient or waiver liability.
- Working Disabled Individuals (MEDWorks): Working disabled individuals may be eligible for MEDWorks, which features slightly higher income limits. However, those enrolled in MEDWorks will be required to pay a monthly premium.
- Institutionalized, Disabled Individuals: This group may be eligible with slightly higher incomes but will likely need to pay a monthly patient liability.
These special cases acknowledge the unique financial needs of individuals requiring specific care or those actively contributing to the workforce despite disabilities.
Asset Test for Medicaid Eligibility
In addition to income limits, Medicaid also imposes an asset test. This test evaluates the value of your countable assets. The asset limits are:
- Single: Maximum of $2,000 in assets
- Married: Maximum of $3,000 in assets
What Counts as an Asset?
Countable assets include items such as:
- Bank account balances
- Cash on hand
- Stocks and bonds
- Property (other than your primary family home)
What Doesn’t Count as an Asset?
Certain assets are exempt from the asset test, including:
- One vehicle
- Your primary home (if it is where you live)
- Burial spaces
Exempting these assets ensures that individuals can maintain essential living standards while still qualifying for Medicaid.
Navigating Medicaid Eligibility
Understanding how much you can make and still qualify for Medicaid involves considering various factors, including your family size, disability status, and the specific Medicaid program. While income and asset limits are crucial, special cases exist that allow for higher income thresholds for certain individuals. By carefully evaluating your circumstances and consulting with Medicaid resources, you can navigate the eligibility process effectively and access the healthcare coverage you need.
