Medicaid Income Eligibility Limits for Adults as a Percent of the Federal Poverty Level | KFF (2024)

FAQs

Does Medicaid cover everyone in the US with an income below 138% of the federal poverty level as of today? ›

In states that have expanded Medicaid coverage: You can qualify based on your income alone. If your household income is below 133% of the federal poverty level, you qualify. (Because of the way this is calculated, it turns out to be 138% of the federal poverty level. A few states use a different income limit.)

To calculate the percentage of the poverty level, divide income by the poverty guideline and multiply by 100.

For an individual, the poverty threshold is $14,891. The U.S. Department of Health and Human Services uses the Census Bureau threshold to determine who is eligible for certain government assistance programs, like SNAP (food stamps).

Of the subtypes of health insurance coverage, employment-based insurance was the most common, covering 54.5 percent of the population for some or all of the calendar year, followed by Medicaid (18.8 percent), Medicare (18.7 percent), direct-purchase coverage (9.9 percent), TRICARE (2.4 percent), and VA and CHAMPVA ...

The federal poverty definition consists of a series of thresholds based on family size and composition. In calendar year 2017, a family of two adults and two children fell in the 200% “poverty” category if their annual income fell below $49,200.

The state with the highest Medicaid income limit is Alaska, where households of eight people must have a maximum income of less than $77,526.

How does Medi-Cal verify income? ›

Pay stub must include: Name of person must be on stub or other identifying information to link to the person (i.e., SSN). Pay stub must be issued within the last 45 days showing the gross amount (include tips, overtime, commission and bonus). A pay stub or check indicating only net amount is not acceptable.

The limits are based on both household income and household size. In 2024, an individual in a one-person household is eligible for some degree of Covered California subsidies if they earn up to $33,975 Meanwhile, that limit rises to $69,375 for a household size of 4.

On December 12, 2019, CMS approved two separate 1115 waivers for South Carolina which would extend Medicaid coverage from 67% to 100% FPL for its parent/caretaker relative groups and a new targeted adult group with initial and continued enrollment conditioned on compliance with work requirements at the regular match ...

United States. In the United States, the poverty thresholds are updated every year by Census Bureau. The threshold in the United States is updated and used for statistical purposes. In 2020, in the United States, the poverty threshold for a single person under 65 was an annual income of US$12,760, or about $35 per day.

In all states, Medicaid provides coverage for some low-income people, families and children, pregnant people, the elderly, and people with disabilities.