Medicaid Eligibility Calculator 2025

Household Size

Monthly Household Income ($)

State Medicaid Expansion Status

Applicant Category

Marital Status

Medicaid Eligibility Status

Enter your information to check eligibility

Income Limit for Your Household

Federal Poverty Level Percentage

Your Income as % of FPL

Annual Income Limit

Official Medicaid Eligibility Guidelines and State Information

How to Use This Medicaid Eligibility Calculator

Enter Household Information

Input your household size and total monthly income from all sources including wages, benefits, and other income.

Select Your State Type

Choose whether your state expanded Medicaid under the Affordable Care Act, as this affects income limits.

Choose Applicant Category

Select your category as different groups have different eligibility requirements and income limits.

Review Your Results

Check your eligibility status, income limits, and Federal Poverty Level percentage to understand your qualification.

What Is the 2025 Medicaid Eligibility Calculator?

The 2025 Medicaid eligibility calculator is a free online tool that helps you find out if you qualify for Medicaid health coverage.

You enter your income, family size, and state to get an instant answer. It’s like having a quick helper that does the math for you.

This tool checks your income against your state’s Medicaid rules. Each state has different income limits.

The calculator uses the Federal Poverty Level to figure this out. It takes all the guesswork away.

When you use the calculator, you’ll need your monthly income, how many people live in your home, and what state you live in. Some programs also ask your age.

Why Use This Calculator?

Medicaid rules can be confusing. Income limits change every year. What works in Texas might not work in California.

Here’s what makes it helpful:

You get instant results with no waiting
It’s updated for 2025 with the newest income limits
It knows your state’s exact rules
It checks different types of Medicaid programs

The calculator gives you a simple yes or no answer. But it also explains why.

You might see results like “You qualify for regular Medicaid” or “Your income is too high for Medicaid.”

Income Limits for 2025

For 2025, most states use these basic rules:

Regular adults: Up to 138% of Federal Poverty Level in expansion states
Seniors needing long-term care: Up to $2,901 per month
Families with children: Usually 138-200% of Federal Poverty Level
Pregnant women: Often up to 200% of Federal Poverty Level or higher

The calculator checks for several Medicaid programs. Regular Medicaid is for low-income adults, children, and families.

Long-term Care Medicaid helps pay for nursing home care. Emergency Medicaid covers urgent medical care only.

There’s also special Medicaid for seniors age 65 and up.

Use this tool when you lost your job, had income changes, or want to check before applying. You can also use it when comparing health insurance options or if your family size changed.

2025 Medicaid Income Limits by State

Medicaid income limits for 2025 vary by state and type of coverage.

Most expansion states allow adults to qualify with income up to 138% of the Federal Poverty Level, which is $21,597 per year for one person in 2025.

For seniors needing long-term care, the income limit is $2,901 per month in most states.

Your state’s Medicaid expansion status makes a big difference. Expansion states cover more people with higher income limits.

Non-expansion states have much lower limits for adults without children.

Income Limits by Coverage Type

Regular Adult Medicaid (Ages 19-64)

Expansion states: Up to $21,597/year ($1,800/month) for one person
Non-expansion states: Often under $5,000/year for adults without kids
The 138% limit includes a 5% income disregard, so more people qualify

Long-Term Care Medicaid (Nursing Homes & Home Care)

Most states: $2,901/month for singles, $5,802/month for couples
Some states have no income limit but use spend-down rules
Covers nursing home care and home health services

Children and Families

Usually 138% to 200% of Federal Poverty Level
Some states go higher for kids
Pregnant women often get higher limits too

State Categories

Expansion States (38 + DC) These states expanded Medicaid in 2014. Adults qualify easier here. States like New York, Pennsylvania, Ohio, and Washington use 138% of Federal Poverty Level.

Non-Expansion States (12 states) These states didn’t expand Medicaid. Adults face much stricter rules. Texas has some of the lowest income limits in the country.

2025 Federal Poverty Level Quick Reference

For 138% of Federal Poverty Level in 2025:

1 person: $21,597/year ($1,800/month)
2 people: $29,172/year ($2,431/month)
3 people: $36,747/year ($3,062/month)
4 people: $44,322/year ($3,694/month)

Add $7,575 for each extra person in your household.

Examples: Top 5 States

California

Regular adults: 138% of Federal Poverty Level ($21,597/year)
Long-term care: No income limit (uses spend-down)
Expansion state with generous coverage

Texas

Regular adults: Very low limits (non-expansion state)
Parents: About 18% of Federal Poverty Level
Long-term care: $2,901/month for singles

Florida

Regular adults: No coverage (non-expansion state)
Parents only: About 32% of Federal Poverty Level
Long-term care: $2,901/month for singles

New York

Regular adults: 138% of Federal Poverty Level
Expansion state with full coverage
Long-term care: $2,901/month for singles

Illinois

Regular adults: 138% of Federal Poverty Level
Long-term care: $1,304/month for singles, $1,762/month for couples
Expansion state but lower long-term care limits

What This Means for You

If you live in an expansion state, you have better chances of qualifying. If you’re in a non-expansion state, you might only qualify if you’re pregnant, have kids, or need long-term care.

Use your state’s Medicaid calculator to get exact numbers. Rules change, and some states have special programs with different limits.

Who Qualifies for Medicaid in 2025?

Medicaid helps millions of Americans get health care. But who can get it? Let’s break down who qualifies for Medicaid in 2025.

Your income matters most. But your age, family size, and health also count. Each state has different rules too.

Here’s who qualifies for Medicaid:

Low-income adults – In states that expanded Medicaid, you qualify if you make 138% of the federal poverty level or less
Pregnant women – Usually qualify at higher income levels than other adults
Children and teens – Get coverage through Medicaid or CHIP up to age 19
Seniors 65 and older – Can get help with Medicare costs
People with disabilities – May qualify even with higher incomes
SSI recipients – Automatically get Medicaid in most states

Medicaid Eligibility for Adults Without Children

Single adults without kids can get Medicaid in expansion states. You need to make less than $20,780 per year in 2025. That’s about $1,732 per month.

If your state didn’t expand Medicaid, it’s harder to qualify. Most states only cover adults without children if they’re pregnant, disabled, or over 65.

You also need to be a U.S. citizen or legal resident. Some states have waiting periods for new residents.

Medicaid Eligibility for Seniors (65+)

Seniors can get two types of Medicaid help:

Full Medicaid covers everything Medicare doesn’t. You need to make less than $967 per month in most states. Some states allow up to $1,304 per month.

Medicare Savings Programs help pay Medicare premiums. Income limits are higher – up to $1,715 per month for single people in 2025.

Your assets matter too. You can’t have more than $2,000 in savings and investments as a single person.

Medicaid Eligibility for People with Disabilities

Disabled adults often qualify for Medicaid through SSI. If you get SSI payments, you automatically get Medicaid in most states.

Don’t get SSI? You might still qualify. Income limits range from $967 to $1,795 per month, depending on your state.

Medicaid covers things Medicare doesn’t, like:

Long-term care
Personal care services
Some prescription drugs
Medical equipment

Medicaid for Pregnant Women and Children

Pregnant women get the best Medicaid coverage. Most states cover pregnant women who make up to 200% of the federal poverty level. That’s about $2,760 per month in 2025.

Some states go even higher. Check your state’s rules.

Children qualify more easily than adults. Most states cover kids in families making up to 200-300% of the poverty level. That’s $55,500-$83,250 per year for a family of four.

CHIP covers kids whose families make too much for Medicaid but can’t afford private insurance.

Medicaid Eligibility Calculator 2025 - FAQ Questions

What is the Medicaid income limit for 2025?

The Medicaid income limit for 2025 is $2,901 per month for single applicants. Married couples can earn up to $5,802 per month. These limits apply to long-term care Medicaid services. Different income limits may apply for regular Medicaid coverage.

How do I calculate my Medicaid eligibility in 2025?

You calculate Medicaid eligibility by comparing your monthly income to state limits. Use your gross monthly income before taxes and deductions. Include all income sources like Social Security and pensions. Most states use 300% of the Federal Benefit Rate as the limit.

What income counts for Medicaid eligibility calculator?

All income sources count for Medicaid eligibility calculations. This includes Social Security benefits, pensions, and wages. Investment income and rental income also count. Some deductions may apply for medical expenses or disabilities.

Do assets affect Medicaid eligibility in 2025?

Yes, assets affect Medicaid eligibility in addition to income limits. Single applicants can have $2,000 in countable assets. Married couples can keep $3,000 in combined assets. Your home and one car usually don't count as assets.

How much money can you make and still qualify for Medicaid 2025?

You can make up to $2,901 per month and still qualify for Medicaid in 2025. This applies to long-term care Medicaid for single applicants. Regular Medicaid has different income limits based on federal poverty levels. Check your state's specific requirements for exact amounts.

What is the Medicaid spend down calculator for 2025?

The Medicaid spend down calculator determines excess income you must pay monthly. You subtract the income limit from your total monthly income. The difference is your spend down amount for medical expenses. This helps you qualify when income exceeds limits.

Does Social Security count as income for Medicaid eligibility?

Yes, Social Security benefits count as income for Medicaid eligibility. This includes Social Security retirement and disability payments. Social Security Supplemental Income (SSI) also counts toward income limits. All monthly Social Security amounts are included in calculations.

Can married couples qualify for Medicaid separately in 2025?

Yes, married couples can qualify for Medicaid separately under spousal impoverishment rules. Only the applying spouse's income counts for eligibility. The healthy spouse can keep more assets and income. Special protections exist for the community spouse's financial security.

What states have expanded Medicaid eligibility in 2025?

Forty states plus Washington DC have expanded Medicaid eligibility in 2025. Expansion states cover adults up to 138% of federal poverty level. Non-expansion states have more limited eligibility for adults. Check if your state expanded Medicaid for broader coverage options.

How often can I use a Medicaid eligibility calculator?

You can use a Medicaid eligibility calculator as often as needed. Check eligibility when income or family size changes. Use the calculator before applying for benefits. Income limits may change annually, so check for current year updates.

What is the difference between regular Medicaid and long-term care Medicaid eligibility?

Regular Medicaid uses federal poverty level guidelines for eligibility. Long-term care Medicaid has higher income limits at $2,901 monthly. Long-term care Medicaid covers nursing home and home care services. Asset limits also differ between the two programs.

Can I qualify for Medicaid if I own a house in 2025?

Yes, you can qualify for Medicaid if you own a house. Your primary residence doesn't count toward asset limits. The home equity limit is $713,000 in most states for 2025. You must live in the home or intend to return.