What Income Is Too High for Medicaid in 2026?
Short answer: it depends on your state and who in the household you're asking about. For adults in the 41 expansion states plus DC, the 2026 ceiling is 138% of the federal poverty level — about $22,025 a year ($1,835/month) for one person and $45,540 a year ($3,795/month) for a family of four. Children and pregnant women qualify at much higher levels — often 150% to 400% of FPL — and in the 10 non-expansion states adults typically don't qualify at any income.
The adult ceiling in dollars: 138% FPL
The table below is the 2026 adult expansion ceiling for every household size, computed from the official HHS poverty guidelines with the federal 5% MAGI disregard applied. The percentage is set by federal law; the dollars change every January when HHS publishes new guidelines.
| Household size | Max income per year | Max income per month |
|---|---|---|
| 1 person | $22,025 | $1,835 |
| 2 people | $29,863 | $2,489 |
| 3 people | $37,702 | $3,142 |
| 4 people | $45,540 | $3,795 |
| 5 people | $53,378 | $4,448 |
| 6 people | $61,217 | $5,101 |
| 7 people | $69,055 | $5,755 |
| 8 people | $76,894 | $6,408 |
Source: 2026 HHS federal poverty guidelines × 138%, with the 5% MAGI disregard. Alaska and Hawaii use larger poverty guidelines, so their dollar ceilings run higher than the figures above.
“Too high” is different for every coverage group
Expansion adults (19–64)
138% FPL — the numbers in the table above. This is the group most people mean when they ask “what income is too high for Medicaid?” Go over it and the adult loses Medicaid coverage — unless an exemption or a transition rule applies.
Children
Far higher than the adult ceiling: commonly 150% to 300%+ of FPL in Medicaid, with separate CHIP programs reaching 200% to 405% depending on the state. A family whose adults are over the limit usually still qualifies for the kids — check your state's children's table.
Pregnant women
Every state covers pregnancy at a higher level than the adult standard — commonly 138% to 263%+ of FPL, and higher still in some states. Over the adult ceiling but pregnant? Check the pregnancy table for your state before assuming you're over.
Non-expansion states (10)
No adult expansion ceiling because there is no adult coverage at all: childless adults don't qualify at any income, and parents qualify only at a very low state standard (often below 50% FPL). If you live in one of these states, the “too high” question is usually reversed — it's too low to matter.
Over the limit? The order to check things
- ✓ Are you actually in the adult group? Pregnant women, parents in some states, people over 65, and people with disabilities have different — often higher — ceilings.
- ✓ The 5% MAGI disregard applies to your gross income before the test — income slightly over the published dollar figure may still pass once the disregard is applied.
- ✓ If the adult is over, check the children and pregnancy tables for the same household — a child can qualify while a parent does not.
- ✓ For the adult: an ACA marketplace plan with premium tax credits (the 400% FPL subsidy cliff returned for 2026) or a state-funded option where one exists.
Ranked fallbacks after losing Medicaid — see the coverage alternatives guide, and estimate your marketplace subsidy at 400% FPL.
One thing that is NOT an income limit: the 2027 work requirement
Starting January 1, 2027, expansion adults must document 80 hours a month of work or qualifying activity to keep coverage. That is a compliance rule, separate from the income ceilings above — earning more than $580/month can satisfy it as the income alternative, but it never makes you ineligible for Medicaid. You can still be under the income ceiling and lose coverage for missing the hours, or be exempt entirely.
Run the 80-hour vs $580 calculator · The $580/month income alternative guide · Check whether you're exempt first
Frequently asked questions
What income is too high for Medicaid?
There is no single national number — the ceiling depends on your state and your coverage group. For expansion adults in the 41 states plus DC, the 2026 ceiling is 138% of the federal poverty level: about $22,025 a year ($1,835 a month) for a household of one, and $45,540 a year ($3,795 a month) for a family of four. Children and pregnant women qualify at far higher thresholds in most states. In the 10 non-expansion states, adults typically do not qualify for Medicaid at any income.
What salary is too high for Medicaid?
For working adults in an expansion state the rule of thumb is: gross income above roughly $1,835 a month for one person (about $22,025 a year, 138% FPL in 2026) is over the adult ceiling. The cutoff scales with household size — a family of four can earn about $3,795 a month ($45,540 a year). The same salary that disqualifies an adult can still leave a child eligible, because children's ceilings are higher.
How much money can you make and still get Medicaid?
For expansion adults in 2026: up to $22,025 a year for one person, $29,863 for two, and $45,540 for a family of four — 138% of the federal poverty level. Earn more and the adult typically no longer qualifies, but children and pregnant women keep much higher ceilings in every state, often 150% to 400% of FPL depending on the state.
What is the maximum income for Medicaid?
There is no single maximum — each coverage group has its own cap. The adult expansion ceiling is 138% FPL (about $22,025 a year for one person in 2026). Children's and pregnancy ceilings run far higher — commonly 150% to 300%+ of FPL, up to 405% in New York's Child Health Plus. A family can be above one ceiling and still qualify under another group.
Can I get Medicaid if I work full time?
Yes — for the adult expansion group, eligibility is income-based, not hours-based. In 2026 an expansion-state adult can earn up to $22,025 a year (about $10.59/hour at full time) and still qualify; a family of four up to $45,540. Working full time does not disqualify you. Separately, beginning January 1, 2027, expansion adults must document 80 hours a month of work or qualifying activity to keep coverage — but that is a compliance rule, not an income limit.
What happens if my income is over the Medicaid limit?
If an adult is over the expansion ceiling, Medicaid won't cover that adult — but the rest of the household may still qualify: children typically have much higher income limits, and pregnant women have their own higher standard. For the adult, an ACA marketplace plan with premium tax credits is the usual next step (the 400% FPL subsidy cliff returned for 2026). See the coverage alternatives guide for ranked options.
Reviewed by Gavin YE, Technical Director, ClearRules Labs.
Page last reviewed 2026-09-29