Free Medicaid Eligibility Checker — All 50 States

Check Medicaid and CHIP eligibility for your state using MAGI rules, the 2025 Federal Poverty Guidelines, and state-specific FPL thresholds. Includes coverage-gap warnings.

Enter your details
$
Result
Enter your details on the left, then press Calculate.

What is this calculator for?

You lost your job two months ago, your COBRA is expiring next week, and you're trying to figure out if your family qualifies for Medicaid before paying $1,400/month for an ACA plan on the marketplace. Medicaid is the largest US health insurance program — about 91 million enrollees as of 2024 — covering low-income families, pregnant women, children, disabled adults, and (in expansion states) all low-income adults regardless of family status. Eligibility is based on income relative to the Federal Poverty Level (FPL), with thresholds that vary by state.

Medicaid income eligibility (Modified Adjusted Gross Income, MAGI) for adult coverage. In 40 states + DC that expanded Medicaid under the ACA: adults qualify up to 138% FPL ($20,783 single, $43,056 family of 4 for 2024). In 10 non-expansion states (Texas, Florida, Georgia, Tennessee, S. Carolina, Alabama, Mississippi, Wisconsin (limited), Kansas, Wyoming): adults usually qualify only if pregnant, parent of qualifying child, disabled, or otherwise categorically eligible — often at much lower thresholds (50-100% FPL in some cases, often only for parents not childless adults). Children and pregnant women have higher income limits in nearly all states (often 200%+ FPL for children via CHIP).

This calculator estimates Medicaid eligibility based on household income, household size, and state. It identifies expansion vs non-expansion status and shows the dollar thresholds. For actual enrollment, apply through your state's Medicaid agency or healthcare.gov.

How to use this calculator

Enter household size: the people you'd cover under Medicaid (often the same as your tax household). Households with both parents + kids count all members.

Enter annual household income (gross MAGI from your tax return). Most state programs use the same income definition: AGI plus tax-exempt interest plus non-taxable Social Security benefits. Standard W-2 income, self-employment income, rental income, retirement distributions all count.

Select your state. The calculator applies the appropriate eligibility threshold based on Medicaid expansion status. For expansion states: 138% FPL across most adult categories. For non-expansion states: complex carved categories with different thresholds.

Indicate special circumstances: pregnant, parent of dependent child, age 65+, blind or disabled. These categorically qualify some people in non-expansion states or at higher income levels.

The calculator outputs eligibility status (likely qualifies, may qualify, doesn't qualify), income threshold for your situation, and application portal for your state.

Understanding your results

The calculator returns whether you likely qualify, may qualify with documentation, or don't qualify based on income. Plus a dollar-amount margin showing how close to the threshold you are.

The expansion-state experience. A family of 4 in California with $35K AGI: well below 138% FPL ($43,056 for household of 4). Almost certainly qualifies for Medi-Cal (California's Medicaid). Application via Covered California or directly at the county; typically processed in 30-45 days. No premiums for most enrollees, minimal copays.

The non-expansion state coverage gap. Same family of 4 in Texas with same $35K. Texas didn't expand Medicaid; childless adults don't qualify for income-based Medicaid. Parents may qualify only if income is below ~17% FPL (extremely low). Children at $35K family income probably qualify for CHIP (Children's Health Insurance Program — separate program, similar enrollment). Pregnant women may qualify up to 200% FPL even in TX. The parents in this scenario are in the "coverage gap" — too poor for ACA subsidies (which require 100%+ FPL income), not eligible for Medicaid. They'd typically end up uninsured or paying full ACA prices ($1,500+/month for family coverage). About 2 million Americans are in this coverage gap as of 2024, mostly in southern non-expansion states.

The ACA subsidy backup. For households slightly above Medicaid threshold (above 138% FPL but below 400% FPL), ACA premium tax credits make marketplace coverage affordable. The Inflation Reduction Act extended subsidies through 2025 with no income cap on the upper end (capping premiums at 8.5% of income). This means a family that just missed Medicaid eligibility ($45K instead of $43K for family of 4) gets ACA subsidies bringing premiums to ~$340/month for a Silver plan — manageable. The "Medicaid cliff" of being just above eligibility creates much less financial pain than being in the actual coverage gap.

Children almost always have separate eligibility. CHIP covers children in families with incomes too high for parent's Medicaid but below the state's CHIP threshold (varies 200-400% FPL). In Texas at $35K family: parents in gap, but children covered by Texas Children's Medicaid or CHIP. Kids typically have separate dental and vision coverage included. The result: many low-income families have a split coverage situation — kids on Medicaid/CHIP, parents on ACA marketplace.

A worked example

Aisha, 34, single mother of two children (5 and 8), lives in Atlanta, Georgia. She lost her job 8 weeks ago and her unemployment ($380/week × ~26 weeks = $9,880 expected total) plus part-time gig income ($14,000 estimated for the year) puts her annual income around $23,880. Georgia did not expand Medicaid.

Eligibility check by category:

Aisha (adult): Georgia adult Medicaid requires parents to have income under approximately 41% FPL or be categorically eligible. Her income at $23,880 for household 3 = ~111% FPL. She's above the parent threshold AND not categorically eligible (not pregnant, not 65+, not disabled). She does not qualify for Medicaid. She's also above 100% FPL, so she does qualify for ACA premium tax credits. ACA Silver plan estimated $40-80/month after subsidies.

Children: GA Medicaid for children covers up to 200% FPL. Both kids easily qualify at 111% FPL — coverage is free or near-free. They apply via PeachCare/GA Medicaid; coverage approved within 30 days.

Result: kids covered by Medicaid (essentially free), Aisha covered by subsidized ACA Silver (~$60/month after PTC). Total family healthcare cost: ~$60/month. Affordable.

Alternative: same Aisha in California. CA Medi-Cal expansion threshold: 138% FPL for adults = $35,632 for household of 3. Her $23,880 well below. Whole family qualifies for Medi-Cal: zero premium, minimal copays. Plus, California state ACA add-on subsidies make any future income changes between Medi-Cal and middle-class incomes smoother (no Medicaid cliff effect).

Difference between her experience in GA vs CA: same income, same family, $720/year cost in GA ($60/month for her ACA coverage) vs $0 in CA. Over a decade if she stays at this income level: $7,200 of healthcare cost difference. The Medicaid expansion vs non-expansion state choice has real financial consequences for lower-income families.

State-by-state variations

Medicaid expansion states (40 + DC, as of 2024): AK, AZ, AR, CA, CO, CT, DE, DC, HI, ID, IL, IN, IA, KY, LA, ME, MD, MA, MI, MN, MO, MT, NE, NV, NH, NJ, NM, NY, NC (started 2023), ND, OH, OK, OR, PA, RI, SD (2023), UT (limited), VT, VA, WA, WV. All cover adults up to 138% FPL.

Non-expansion states (10): TX, FL, GA, AL, MS, SC, TN, WI (limited expansion via 1115 waiver), KS, WY. Adults must be categorically eligible (pregnant, parent of dependent child, disabled, or pregnant). Income thresholds for parents vary: TX ~17% FPL for parents; FL ~30% FPL; GA ~37% FPL; AL ~13% FPL (extremely low).

Coverage differences. Expansion states cover a broader range of services (mental health, substance abuse treatment, expanded dental, vision in some). Non-expansion states' Medicaid programs are smaller and often have different benefits. CHIP (children) is universally available regardless of state expansion status — kids covered up to 200-400% FPL depending on state.

Asset tests. For income-based Medicaid (the focus here), there's typically no asset test — pure income calculation. For long-term care Medicaid (for nursing home or in-home care needs of older or disabled adults): asset tests apply, typically requiring spend-down of assets to under $2,000 (single) or $5,000 (couple in some states). This is the Medicaid that requires complex estate planning, not the income-based adult Medicaid.

Application timing. Most states process applications within 30-45 days; emergency situations (pregnancy, immediate hospitalization) may accelerate. Coverage is retroactive 90 days in most states — so if you applied today but were eligible 30 days ago, your coverage covers those past 30 days. The application portal in each state is typically the state's Medicaid agency or healthcare.gov.

Related resources

For other means-tested federal programs with similar income calculations, see SNAP Eligibility, School Lunch Eligibility, and EITC & CTC Calculator. For health-insurance coverage if income is above Medicaid threshold, the ACA Subsidy Estimator. For tax-advantaged health spending (only for higher-income filers), the HSA & FSA Maximizer. The federal Medicaid.gov portal covers federal program rules; each state's Medicaid agency website has the actual application portal and state-specific rules.

Related calculators

income taxrent affordability

Frequently asked questions

What is MAGI and how does it affect eligibility?

Modified Adjusted Gross Income is the income measure used for most Medicaid determinations since the ACA. It includes wages, salary, self-employment income, Social Security benefits, and tax-exempt interest. It does not count gifts, veterans' benefits, child support received, or SSI.

What is the Medicaid coverage gap?

In states that have not expanded Medicaid under the ACA, adults whose income is too high for traditional Medicaid but below 100% of the Federal Poverty Level fall into a gap — too poor for ACA marketplace subsidies and ineligible for Medicaid. Roughly 10 states currently have this gap.

Can immigrants qualify for Medicaid?

US citizens and lawful permanent residents who have held a green card for 5 or more years are generally eligible if they meet income rules. Recent permanent residents face a 5-year waiting period in most states, though some states use state-only funds to cover them. Undocumented immigrants qualify only for emergency Medicaid services.

Does Medicaid cover the same services as private insurance?

Generally yes, often with broader coverage in some areas. All Medicaid programs must cover: hospitalization, doctor visits, lab/x-ray, prescription drugs, mental health services, family planning, prenatal care, nursing facility services for over-21, home health for some categories, EPSDT (Early and Periodic Screening, Diagnostic, and Treatment) for under-21. Many states cover more: dental and vision (sometimes), physical therapy, occupational therapy, transportation to medical appointments. Network: Medicaid has its own network of providers; not all doctors accept Medicaid. Quality of care: generally good for primary care; sometimes harder to find specialists who take Medicaid (lower reimbursement rates). Free of premiums for most enrollees; copays minimal ($1-5 for prescriptions, $5-15 for visits) and often waived for children.

Can I have both Medicaid and Medicare?

Yes — called 'dual eligibles.' About 12 million Americans qualify for both. Medicare (age 65+, or under 65 with certain disabilities) is primary; Medicaid covers what Medicare doesn't (Medicare premiums, copays, deductibles, services Medicare doesn't cover like long-term care). The Medicare Savings Programs help low-to-moderate income Medicare beneficiaries: QMB (Qualified Medicare Beneficiary) pays all Medicare premiums and cost-sharing for incomes under 100% FPL. SLMB (Specified Low-Income Medicare Beneficiary) helps with Part B premium for 100-120% FPL. Apply through your state Medicaid agency.

What's the difference between Medicaid and Medicare?

Medicare: federal program, age 65+ (or under 65 with certain disabilities), available regardless of income, has Part A (hospital), Part B (medical), Part D (drugs), and Part C (Medicare Advantage as private alternative). Has premiums ($174.70/month standard Part B in 2024), deductibles, copays. Medicaid: federal + state partnership, based on income (and sometimes other categorical eligibility), available regardless of age. Free or near-free for enrollees. Different eligibility, different benefits, different networks, sometimes available simultaneously (dual eligibles).

What if I'm over the Medicaid income limit but can't afford insurance?

ACA marketplace with subsidies. Premium tax credits dramatically reduce monthly costs for households between 100-400% FPL (and through 2025, no upper income cap). For a family of 4 at $50,000 (slightly above Medicaid in expansion states, around 165% FPL): typical premiums after subsidy run $40-200/month for Silver plan. The ACA + Inflation Reduction Act extensions made marketplace coverage genuinely affordable for most middle-income families. The exception is the 'coverage gap' in non-expansion states for adults below 100% FPL who don't categorically qualify for Medicaid and aren't eligible for ACA subsidies (which require 100%+ FPL income).

Can I lose Medicaid if my income increases?

Yes — Medicaid is means-tested. Income increases above the eligibility threshold trigger loss of coverage at the next annual redetermination (or sooner if you report the change). Transition support: when losing Medicaid for income reasons, you typically qualify for ACA premium tax credits at the new income level — the marketplace 'special enrollment period' for loss of Medicaid gives 60 days to enroll without waiting for open enrollment. Many people are surprised by how affordable subsidized marketplace coverage is at incomes just above Medicaid thresholds — often only $40-100/month for individual coverage. The 'losing Medicaid means uninsured' fear is usually unfounded if you're working and earning above the threshold.

Sources