Estimate whether your household qualifies for Medicaid based on income, household size, and Federal Poverty Level guidelines.
Medicaid provides free or low-cost health coverage to millions of Americans with limited income. Eligibility is primarily based on your Modified Adjusted Gross Income (MAGI) as a percentage of the Federal Poverty Level (FPL).
In states that expanded Medicaid under the ACA, adults with income up to 138% FPL qualify. In non-expansion states, eligibility is more restrictive and varies. Children, pregnant women, and disabled individuals often have higher income thresholds.
This calculator estimates your FPL percentage and whether you may qualify for Medicaid based on income and household size. These are educational estimates only — actual eligibility depends on your state's rules and complete application. Whether you are a beginner or experienced professional, this free online tool provides instant, reliable results without manual computation. By automating the calculation, you save time and reduce the risk of costly errors in your planning and decision-making process. This tool handles all the complex arithmetic so you can focus on interpreting results and making informed decisions based on accurate data.
Medicaid eligibility rules are complex and many eligible people don't know they qualify. This calculator provides a quick check of your income relative to poverty guidelines, helping you decide whether to apply. Having a precise figure at your fingertips empowers better planning and more confident decisions. Manual calculations are error-prone and time-consuming; this tool delivers verified results in seconds so you can focus on strategy.
FPL Base (1 person, 2024) = $15,060 Each additional person adds $5,380 FPL Threshold for household = $15,060 + ($5,380 × (household size − 1)) FPL % = (Household Income / FPL Threshold) × 100 Medicaid Eligible if FPL % ≤ 138% (expansion states) or state-specific threshold
Result: FPL: 116% | Likely eligible (expansion state, ≤138%)
FPL for a family of 3 = $15,060 + (2 × $5,380) = $25,820. Income $30,000 / $25,820 = 116% FPL. In an expansion state, eligibility is up to 138% FPL, so this household likely qualifies for Medicaid.
Medicaid uses MAGI-based income counting, which is simpler than the old rules. Most deductions from your tax return apply, making your qualification predictable. The 138% FPL threshold in expansion states includes a 5% income disregard, so the effective limit is technically 133% FPL with a 5% buffer.
In the 10 non-expansion states, adults earning less than 100% FPL may be in a "coverage gap" — too much income for traditional Medicaid, too little for ACA marketplace subsidies (which start at 100% FPL). Approximately 1.6 million Americans fall into this gap.
If your income increases above the Medicaid threshold, you transition to ACA marketplace plans with premium tax credits. The transition should be seamless — report income changes promptly to avoid coverage gaps. ACA subsidies make marketplace plans affordable for those just above Medicaid limits.
The FPL is an income measure issued annually by HHS used to determine eligibility for federal assistance programs. For 2024, the FPL for one person is $15,060 in the contiguous US. It increases by $5,380 per additional household member. Higher amounts apply in Alaska and Hawaii.
The ACA allowed states to expand Medicaid to all adults with income up to 138% FPL. As of 2024, 40 states plus DC have expanded. In non-expansion states, adults without children often don't qualify regardless of income, creating the "coverage gap" where they earn too little for ACA subsidies.
Modified Adjusted Gross Income includes: wages, salary, self-employment income, Social Security, unemployment, investment income. It does NOT include: child support, workers' comp, gifts, or non-taxable VA benefits. This is generally the same income that appears on your tax return.
Yes! Medicaid is not just for unemployed people. Many working families qualify, especially in expansion states. At 138% FPL, a single person earning $20,783 or a family of 4 earning $43,056 qualifies. Some states also have Medicaid "Buy-In" programs for workers with disabilities.
The Children's Health Insurance Program covers children in families that earn too much for Medicaid but can't afford private insurance. Income limits vary by state but typically range from 200% to 300% FPL (over $62,000–$93,000 for a family of 4). Coverage is comprehensive with low or no premiums.
Apply through your state's Medicaid agency or at Healthcare.gov. You can apply online, by phone, by mail, or in person. Many states process applications within 45 days. You need proof of income, identity, and residence. Coverage can begin the month you apply or even retroactively.