Medicaid Eligibility in 2026: Income Limits, How to Apply, and What It Covers

Updated: April 2026

Medicaid is the largest health insurance program in the United States, covering over 90 million Americans in 2026. If your income is low enough, you may qualify for comprehensive health coverage at little to no cost — regardless of whether you have a job, and even if you’ve been denied coverage before. Here is how eligibility works, who qualifies in your state, and exactly how to apply.

What Is Medicaid?

Medicaid is a joint federal-state health insurance program for people with limited income and resources. The federal government sets minimum standards, but each state administers its own program — which means eligibility rules, covered services, and application processes vary by state.

Key differences from other health coverage:

• No premiums for most enrollees (some states charge small premiums for higher-income adults)
• Very low or no cost-sharing — copays are typically $0-$4 for most services
• No open enrollment period — apply any time, coverage starts quickly
• Retroactive coverage — in many states, Medicaid can cover bills from the 3 months before your application date

2026 Medicaid Income Limits by Household Size

In states that expanded Medicaid under the ACA, the income limit is 138% of the Federal Poverty Level (FPL). Here are the 2026 limits:

Income is counted as Modified Adjusted Gross Income (MAGI) — wages, salaries, tips, and most other income sources. Some income types like child support and veterans’ benefits may be excluded.

Expansion vs. Non-Expansion States

Whether your state expanded Medicaid under the ACA determines how easy it is to qualify as an adult without children:

Check your state’s current expansion status at KFF.org. If you live in a non-expansion state, you may still qualify through other categories (pregnancy, disability, age 65+, or having children in the household).

Who Qualifies for Medicaid?

Beyond income, Medicaid has separate eligibility pathways for specific groups:

• Children (CHIP): Most states cover children in families earning up to 200-300% FPL through CHIP (Children’s Health Insurance Program). Apply through the same process.
• Pregnant women: All states cover pregnancy-related care for women up to at least 138% FPL. Many states cover up to 200-380% FPL.
• Adults with disabilities: Qualify through SSI/Social Security Disability — different income and asset rules apply.
• Adults 65+: Medicare is the primary coverage, but Medicaid can cover Medicare premiums and cost-sharing for low-income seniors (“dual eligibles”).
• Adults in expansion states: Any adult earning under 138% FPL regardless of family status.

Step-by-Step: How to Apply for Medicaid in 2026

Step 1: Check Your State’s Program

Every state has its own Medicaid program with a different name (Medi-Cal in California, TennCare in Tennessee, etc.). Find your state’s program and application at Medicaid.gov.

Step 2: Gather Required Documents

Most applications require:

• Proof of identity (driver’s license, passport, or state ID)
• Proof of income (pay stubs, tax return, employer letter, or self-employment records)
• Proof of residency (utility bill, lease, or bank statement with your address)
• Social Security numbers for all household members applying
• Immigration documents if applicable

Step 3: Choose Your Application Method

You can apply:

• Online: Through Healthcare.gov (connects to your state system) or directly on your state’s Medicaid website
• By phone: Call your state Medicaid agency or 1-800-318-2596 (Healthcare.gov)
• In person: Visit your local Medicaid or social services office
• By mail: Download and mail a paper application

Step 4: Complete and Submit the Application

The online application takes about 30-45 minutes. You’ll need to answer questions about household size, income for each member, current health coverage, and citizenship/immigration status.

Step 5: Wait for a Decision

States are required to process Medicaid applications within 45 days (90 days for disability-based applications). Many states process faster — some approve within days. You can check your application status online or by calling your state agency.

What Does Medicaid Cover?

Federal law requires all state Medicaid programs to cover certain services. Most states cover significantly more:

Most states also cover prescription drugs, dental care, vision, mental health services, and substance use treatment — though specifics vary. Check your state’s benefit list at Medicaid.gov/benefits.

Frequently Asked Questions

Bottom Line

Medicaid in 2026 provides comprehensive, low-cost health coverage for tens of millions of Americans. If your income falls below 138% FPL and you live in an expansion state, you almost certainly qualify — even if you work, own a car, or have some savings. The application is free, can be done online in under an hour, and there is no deadline. Visit Healthcare.gov or your state’s Medicaid site to check your eligibility today.

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