Medicaid provides essential healthcare coverage to millions of Americans, including those with limited income and resources. Understanding the income limits for Medicaid eligibility is crucial. This guide will explain how much you can earn and still qualify for Medicaid, focusing on different family sizes and specific circumstances.
Medicaid offers several programs to serve various populations, including:
- Traditional Medicaid
- Hoosier Care Connect
Medicaid Eligibility Factors
Several factors determine your eligibility for Medicaid:
- 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 has specific income and asset limits, which we will discuss in detail below.
Income Limits Based on Family Size
The income limits for Medicaid eligibility vary based on your family size. These limits are updated periodically, so it’s important to stay informed about the current thresholds.
| 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 the “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 Circumstances: Higher Income Limits
Certain individuals may qualify for Medicaid even with incomes exceeding the standard limits. These exceptions often apply to individuals with disabilities who require specific types of care.
Institutionalized or Home and Community-Based 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; income of the spouse and other household members is not counted. 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 with slightly higher income and will be required to pay a monthly premium. This program is designed to support those who are able to work while receiving Medicaid benefits.
Institutionalized Disabled Individuals
Institutionalized, disabled individuals may be eligible with slightly higher incomes and be required to pay a monthly patient liability. This recognizes the higher costs associated with institutional care.
Asset Limits for Medicaid Eligibility
In addition to income limits, Medicaid also has asset limits. These limits define the maximum value of assets you can own and still qualify for coverage.
- Maximum Asset Limit: $2,000 (single) or $3,000 (married)
What counts as an asset? Assets include bank account balances, cash on hand, stocks and bonds, and property (other than your family home).
What doesn’t count as an asset? Certain assets are exempt from the asset limit, including one vehicle, a home (if it is where you live), and burial spaces.
Navigating Medicaid Eligibility
Understanding the income and asset limits for Medicaid is essential for determining your eligibility. Keep in mind that specific rules and limits may vary by state and program.
For more personalized guidance and to ensure you have the most accurate information, it’s best to consult with a qualified Medicaid specialist or visit your state’s Medicaid website. They can help you navigate the application process and understand the specific requirements in your area.
