Pennsylvania Medicaid Income Limits 2026: Chart by Household Size & Family of 4
Quick answer: most Pennsylvania adults qualify with household income up to $1,835/month (single) — 138% of the 2026 federal poverty guidelines. Children and pregnant women qualify at much higher levels. The chart below lists the Pennsylvania Medicaid income requirements and guidelines for 2026 — all effective cutoffs including the 5% MAGI disregard, computed from the official 2026 FPL table (ASPE / Federal Register). State standards are from the CMS national eligibility table, as of 2023-12-01.
Pennsylvania Medicaid is the Pennsylvania Medicaid program. The 2026 Pennsylvania Medicaid income limits are the figures on this page, shown as both the state percentages and dollar charts by household size.
Pennsylvania Medicaid work requirement 2027: the federal work-requirement deadline for Pennsylvania is January 1, 2027. The income cutoffs on this page are the 2026 figures in effect now; see the Pennsylvania work-requirement page for hours, exemptions and the reporting timeline.
Verification: All figures come from the CMS national eligibility table (2023-12-01 snapshot).
Adults 19-64 (Pennsylvania Medicaid expansion group) — 2026 income limits
138% FPL effectiveAdults 19-64 (Pennsylvania Medicaid expansion group) income limits 2026: 138% of the federal poverty level — about $1,835/month for a household of 1 and $3,795/month for a family of 4.
| Household | Family of 1 | Family of 2 | Family of 3 | Family of 4 | Family of 5 | Family of 6 | Family of 7 | Family of 8 |
|---|---|---|---|---|---|---|---|---|
| Monthly income limit | $1,835 | $2,489 | $3,142 | $3,795 | $4,448 | $5,101 | $5,755 | $6,408 |
Base standard 133% FPL + 5% MAGI disregard = 138% effective. Larger households: add roughly $653/month per additional person.
The ACA expansion group: adults 19-64 who qualify on income alone and are not eligible in another category such as disability or pregnancy. This is the group the 2027 work requirement applies to. No asset test.
Children 0-1 (Medicaid) — 2026 income limits
220% FPL effectiveChildren 0-1 (Medicaid) income limits 2026: 220% of the federal poverty level — about $2,926/month for a household of 1 and $6,050/month for a family of 4.
| Household | Family of 1 | Family of 2 | Family of 3 | Family of 4 | Family of 5 | Family of 6 | Family of 7 | Family of 8 |
|---|---|---|---|---|---|---|---|---|
| Monthly income limit | $2,926 | $3,967 | $5,009 | $6,050 | $7,091 | $8,133 | $9,174 | $10,215 |
Base standard 215% FPL + 5% MAGI disregard = 220% effective. Larger households: add roughly $1,041/month per additional person.
Medicaid coverage for children. No premiums and no asset test.
Children 1-5 (Medicaid) — 2026 income limits
162% FPL effectiveChildren 1-5 (Medicaid) income limits 2026: 162% of the federal poverty level — about $2,155/month for a household of 1 and $4,455/month for a family of 4.
| Household | Family of 1 | Family of 2 | Family of 3 | Family of 4 | Family of 5 | Family of 6 | Family of 7 | Family of 8 |
|---|---|---|---|---|---|---|---|---|
| Monthly income limit | $2,155 | $2,921 | $3,688 | $4,455 | $5,222 | $5,989 | $6,755 | $7,522 |
Base standard 157% FPL + 5% MAGI disregard = 162% effective. Larger households: add roughly $767/month per additional person.
Medicaid coverage for children. No premiums and no asset test.
Children 6-18 (Medicaid) — 2026 income limits
138% FPL effectiveChildren 6-18 (Medicaid) income limits 2026: 138% of the federal poverty level — about $1,835/month for a household of 1 and $3,795/month for a family of 4.
| Household | Family of 1 | Family of 2 | Family of 3 | Family of 4 | Family of 5 | Family of 6 | Family of 7 | Family of 8 |
|---|---|---|---|---|---|---|---|---|
| Monthly income limit | $1,835 | $2,489 | $3,142 | $3,795 | $4,448 | $5,101 | $5,755 | $6,408 |
Base standard 133% FPL + 5% MAGI disregard = 138% effective. Larger households: add roughly $653/month per additional person.
Medicaid coverage for children. No premiums and no asset test.
Children (separate CHIP — Pennsylvania CHIP) — 2026 income limits
319% FPL effectiveChildren (separate CHIP — Pennsylvania CHIP) income limits 2026: 319% of the federal poverty level — about $4,243/month for a household of 1 and $8,773/month for a family of 4.
| Household | Family of 1 | Family of 2 | Family of 3 | Family of 4 | Family of 5 | Family of 6 | Family of 7 | Family of 8 |
|---|---|---|---|---|---|---|---|---|
| Monthly income limit | $4,243 | $5,753 | $7,263 | $8,773 | $10,282 | $11,792 | $13,302 | $14,812 |
Base standard 314% FPL + 5% MAGI disregard = 319% effective. Larger households: add roughly $1,510/month per additional person.
Separate CHIP coverage for uninsured children above the Medicaid children's ceiling, under the Pennsylvania CHIP name. Benefits match Medicaid; small copays may apply for some services.
Pregnant women — 2026 income limits
220% FPL effectivePregnant women income limits 2026: 220% of the federal poverty level — about $2,926/month for a household of 1 and $6,050/month for a family of 4.
| Household | Family of 1 | Family of 2 | Family of 3 | Family of 4 | Family of 5 | Family of 6 | Family of 7 | Family of 8 |
|---|---|---|---|---|---|---|---|---|
| Monthly income limit | $2,926 | $3,967 | $5,009 | $6,050 | $7,091 | $8,133 | $9,174 | $10,215 |
Base standard 215% FPL + 5% MAGI disregard = 220% effective. Larger households: add roughly $1,041/month per additional person.
Count the expected child(ren) in household size. Federal law guarantees 12 months of postpartum coverage. No asset test.
Parents & caretaker relatives — 2026 income limits
38% FPL effectiveParents & caretaker relatives income limits 2026: 38% of the federal poverty level — about $505/month for a household of 1 and $1,045/month for a family of 4.
| Household | Family of 1 | Family of 2 | Family of 3 | Family of 4 | Family of 5 | Family of 6 | Family of 7 | Family of 8 |
|---|---|---|---|---|---|---|---|---|
| Monthly income limit | $505 | $685 | $865 | $1,045 | $1,225 | $1,405 | $1,585 | $1,764 |
Base standard 33% FPL + 5% MAGI disregard = 38% effective. Larger households: add roughly $180/month per additional person.
The parents and caretaker relatives category — in an expansion state, parents above this line qualify through the adult expansion group instead.
Pennsylvania publishes MAGI standards as a percent of FPL and applies the federal 5-percentage-point income disregard when it makes someone eligible, so each group has a base standard and a slightly higher effective cutoff. The tables below show the effective figures in dollars, computed from the official 2026 federal poverty guidelines.
MAGI household size follows federal tax-filing relationships, not who lives under your roof - and a pregnant applicant counts the expected child(ren).
Pennsylvania Medicaid income limits 2025 (prior year)
If you are checking last year's figures — for example pennsylvania medicaid income limits 2025 family of 4 — here is the 2025 table, computed from the 2025 federal poverty guidelines ($15,650/year for a household of one, published January 2025). Official HHS 2025 Poverty Guidelines (48 contiguous states and DC): first person $15,650, each additional person +$5,500, four-person family $32,150, published January 2025 in the Federal Register. States adopt each year's guidelines into their MAGI income standards early in the year, so 2025 figures applied to most determinations during 2025 and into early 2026.
| Coverage group | Family of 1 | Family of 2 | Family of 3 | Family of 4 | Family of 5 |
|---|---|---|---|---|---|
| Adults 19-64 (Pennsylvania Medicaid expansion group) | $1,800 | $2,432 | $3,065 | $3,697 | $4,330 |
| Children 0-1 (Medicaid) | $2,869 | $3,878 | $4,886 | $5,894 | $6,903 |
| Children 1-5 (Medicaid) | $2,113 | $2,855 | $3,598 | $4,340 | $5,083 |
| Children 6-18 (Medicaid) | $1,800 | $2,432 | $3,065 | $3,697 | $4,330 |
| Children (separate CHIP — Pennsylvania CHIP) | $4,160 | $5,622 | $7,084 | $8,547 | $10,009 |
| Pregnant women | $2,869 | $3,878 | $4,886 | $5,894 | $6,903 |
| Parents & caretaker relatives | $496 | $670 | $844 | $1,018 | $1,192 |
For anything decided today, use the 2026 tables above — those are the figures Pennsylvania Department of Human Services applies now.
Frequently asked questions
What is the Pennsylvania Medicaid income limit in 2026?
It depends on the coverage group. most Pennsylvania adults qualify with household income up to $1,835/month (single) — 138% of the 2026 federal poverty guidelines. Children and pregnant women qualify at much higher levels.
What is the Pennsylvania Medicaid income limit for a family of 2?
Adults 19-64 (Pennsylvania Medicaid expansion group) — 138% of the federal poverty level, about $2,489/month for a family of 2 in 2026. The ACA expansion group: adults 19-64 who qualify on income alone and are not eligible in another category such as disability or pregnancy. This is the group the 2027 work requirement applies to. No asset test.
What is the Pennsylvania Medicaid income limit for a family of 3?
Adults 19-64 (Pennsylvania Medicaid expansion group) — 138% of the federal poverty level, about $3,142/month for a family of 3 in 2026. The ACA expansion group: adults 19-64 who qualify on income alone and are not eligible in another category such as disability or pregnancy. This is the group the 2027 work requirement applies to. No asset test.
What is the Pennsylvania Medicaid income limit for a family of 4?
Adults 19-64 (Pennsylvania Medicaid expansion group) — 138% of the federal poverty level, about $3,795/month for a family of 4 in 2026. The ACA expansion group: adults 19-64 who qualify on income alone and are not eligible in another category such as disability or pregnancy. This is the group the 2027 work requirement applies to. No asset test.
What is the Pennsylvania Medicaid income limit for a family of 5?
Adults 19-64 (Pennsylvania Medicaid expansion group) — 138% of the federal poverty level, about $4,448/month for a family of 5 in 2026. The ACA expansion group: adults 19-64 who qualify on income alone and are not eligible in another category such as disability or pregnancy. This is the group the 2027 work requirement applies to. No asset test.
What income is too high for Medicaid in Pennsylvania?
There is no single number — every coverage group has its own ceiling. In Pennsylvania, an adult under 65 qualifies with household income up to $1,835/month for one person (138% FPL). Go above that and the adult group no longer covers you. Children and pregnant women stay covered at much higher levels: children to 220% FPL and pregnant women to 220% FPL.
What is the income limit for Adults 19-64 in Pennsylvania?
Adults 19-64 (Pennsylvania Medicaid expansion group): 138% of the federal poverty level, about $1,835/month for a household of one. The ACA expansion group: adults 19-64 who qualify on income alone and are not eligible in another category such as disability or pregnancy. This is the group the 2027 work requirement applies to. No asset test.
What is the income limit for Children 0-1 in Pennsylvania?
Children 0-1 (Medicaid): 220% of the federal poverty level, about $2,926/month for a household of one. Medicaid coverage for children. No premiums and no asset test.
What is the income limit for Children 1-5 in Pennsylvania?
Children 1-5 (Medicaid): 162% of the federal poverty level, about $2,155/month for a household of one. Medicaid coverage for children. No premiums and no asset test.
What is the income limit for Children 6-18 in Pennsylvania?
Children 6-18 (Medicaid): 138% of the federal poverty level, about $1,835/month for a household of one. Medicaid coverage for children. No premiums and no asset test.
What is the income limit for Children in Pennsylvania?
Children (separate CHIP — Pennsylvania CHIP): 319% of the federal poverty level, about $4,243/month for a household of one. Separate CHIP coverage for uninsured children above the Medicaid children's ceiling, under the Pennsylvania CHIP name. Benefits match Medicaid; small copays may apply for some services.
What are the Pennsylvania Medicaid income limits for seniors (65 and older)?
The limits above are MAGI standards for children, pregnant women, parents and adults under 65. People 65 or older (and people with disabilities of any age) qualify under separate non-MAGI categories with their own dollar limits, which can include an asset test. Pennsylvania Department of Human Services publishes those figures and makes the final determination.
What are the Pennsylvania Medicaid income limits in 2026?
Pennsylvania Medicaid is the Pennsylvania Medicaid program. Its income limits are the ones on this page: most Pennsylvania adults qualify with household income up to $1,835/month (single) — 138% of the 2026 federal poverty guidelines. Children and pregnant women qualify at much higher levels.
What were the Pennsylvania Medicaid income limits in 2025?
Pennsylvania's eligibility categories and percentages are set in state regulation and did not change between 2025 and 2026 — only the federal poverty guidelines did. Under the 2025 guidelines ($15,650/year for a household of one, published January 2025), the Adults 19-64 (Pennsylvania Medicaid expansion group) group meant about $1,800/month for one and $3,697/month for a family of 4. The full 2025 table is below; use the 2026 table above for current determinations.
Sources
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Reviewed by Gavin YE, Technical Director, ClearRules Labs.
Page last reviewed 2026-09-21