Am I eligible for Medicaid?

If you're under 65 and working a low-wage job, MAGI Medicaid is your doorway. In expansion states, the income limit reaches 138% of poverty — around $20,800 a year for one person, around $35,600 for a household of three at the 2026 federal poverty guideline. There's no asset test on this pathway. The IRS-style MAGI calculation is what counts (your wages plus a few adjustments), not what's in your bank account.

In non-expansion states the limit drops dramatically — often parent-only with very low income thresholds. If you're in a non-expansion state and just above the cutoff, look at the Marketplace with subsidies as the bridge.

If you're 65+ or disabled, the rules change — see the next card.

Once you turn 65, you leave the MAGI doorway and enter Aged, Blind, and Disabled (ABD) Medicaid. Two big differences: (1) income limits are typically tied to SSI rules — lower than MAGI; (2) asset limits matter. The federal floor for SSI-linked Medicaid is $2,000 for an individual and $3,000 for a couple, though many states use higher limits.

Your state matters a lot here. In '1634 states' (about 32 states plus DC), if you qualify for SSI you automatically get Medicaid. In '209(b) states,' rules can be stricter than SSI. In 'criteria-only states,' you apply for Medicaid separately even if you have SSI. The ABD pathway also has dual-eligible coordination if you also have Medicare.

Need long-term care or nursing-home Medicaid? See the LTC card.

ABD Medicaid has a disability doorway distinct from SSI or SSDI. Some states use SSI's medical disability standard for the determination, even without you actually receiving SSI cash benefits. Some states have 'medically needy' programs that let you 'spend down' medical bills to qualify even if your income is above the standard cutoff.

If you're on SSDI and your income is low enough, you may qualify for both Medicare and Medicaid (dual-eligible). Working-disabled buy-in programs exist in many states under Section 1619(b) of the Social Security Act — these let you keep Medicaid while working at higher income levels. Apply through your state Medicaid agency.

Already on SSI? You may have Medicaid automatically in 1634 states.

Pregnancy Medicaid is its own income window. Many states extend coverage up to 200% of poverty or higher — some go beyond 300% — because the federal government allows states to set the limit higher for pregnant individuals than for other adults. There's no asset test on this pathway.

In states that have adopted the 12-month postpartum coverage extension (most have), your Medicaid keeps running for 12 months after birth. Apply through your state Medicaid agency or Healthcare.gov. Don't wait — prenatal care matters from the first trimester.

Already have kids in the household? Check the kids/CHIP card.

Long-term care Medicaid is the most complex of the four doorways. Different income rules. Different asset rules. A 5-year look-back on asset transfers. Spousal-impoverishment protections that let a 'community spouse' keep a portion of the assets. State-specific home-equity caps. And estate recovery rules that can come back at the estate after death.

This is the doorway where the rules can hurt you if you don't know them. Don't transfer assets without legal guidance — a transfer in the wrong window can disqualify your parent for years. Talk to an elder-law attorney before doing anything.

Want home-based care instead of nursing home? Look up HCBS waivers.

Kids almost always have higher income limits than adults. In most states, children up to 200% of poverty qualify for Medicaid; CHIP picks up where Medicaid leaves off, typically running up to 250%, 300%, or even 400% of poverty depending on the state.

In most states, the same agency runs Medicaid and CHIP, and one application covers both. If your household income is above the adult Medicaid cutoff but below the kids' line, your kids may qualify even when you don't. Check Healthcare.gov or your state Medicaid agency — same screener, same application.

Pregnant? See the pregnancy card. Adult coverage too? Check MAGI.

If you're helping a parent or partner figure out if they qualify, here's the route-finding sequence I use:

1. Age. Under 65 is MAGI territory. 65+ is ABD. (A disability under 65 routes to ABD too.)

2. Disability status. If they're disabled — even without SSDI or SSI — there's an ABD pathway. Some states use SSI's medical standard for the determination.

3. Long-term care need. If they need a nursing home or in-home help (HCBS waiver), LTC Medicaid is its own world — talk to an elder-law attorney before transferring assets.

4. Income and assets. Get a rough number. Don't pre-disqualify them — most people guess wrong.

5. State. Pull up your state Medicaid agency website or call 2-1-1.

If they're on Medicare and you're on the dual-eligible track, SHIP (1-877-839-2675) is your free helper — trained counselors who handle Medicare-Medicaid coordination. Bring documents: ID, proof of income, list of assets, citizenship/immigration status, household composition.

Helping with Medicare too? SHIP at 1-877-839-2675 is free.

Medicaid eligibility has more sub-pathways than fit on one page — medically needy, working-disabled buy-in, breast and cervical cancer treatment program, former foster youth coverage, refugee medical assistance, Emergency Medicaid for non-qualified immigrants, and more. If your situation doesn't match the six cards above, you're not alone, and a denial isn't the end.

Start with your state Medicaid agency. Ask: 'What pathways do I qualify under in this state?' Then call 2-1-1 (United Way) for help walking through the application. Legal Aid in your state can help if you've been denied and think the denial was wrong. Email me at the bottom of this page — I'll add your situation to the next version of this guide.