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2025 Medicaid Income Chart – Who Qualifies and Who Gets Cut? – LKO Uniexam.in

2025 Medicaid Income Chart
2025 Medicaid Income Chart

2025 Medicaid Income Chart: Medicaid provides essential health coverage to millions of Americans, including low-income families, seniors, and individuals with disabilities. However, income limits for Medicaid eligibility vary by state, household size, and specific program rules. As 2025 brings updated Federal Poverty Level (FPL) guidelines, some individuals may gain or lose eligibility due to income changes.

If you’re wondering who qualifies for Medicaid in 2025 and whether you meet the income requirements, this guide will walk you through the income limits, eligibility rules, and key changes.

2025 Medicaid Income Chart

Feature Details
Income-Based Eligibility Based on the Federal Poverty Level (FPL), which is updated annually
Medicaid Expansion States 38 states + D.C. offer coverage for those earning up to 138% of FPL
Non-Expansion States Medicaid is only available for specific groups (seniors, disabled, pregnant women, children)
2025 FPL Guidelines 1 person: $14,580/year, 4 people: $30,000/year (100% FPL)
Who May Lose Medicaid? Individuals whose income exceeds their state’s threshold
Where to Apply? Medicaid.gov or your state’s health department

Medicaid remains a critical safety net for millions of Americans, but income limits and eligibility rules vary widely across states. With 2025 bringing updated FPL guidelines, it’s essential to check if you still qualify.

Key Takeaways:

  • Medicaid eligibility is based on income, household size, and state rules.
  • Expansion states cover adults earning up to 138% of FPL; non-expansion states have stricter limits.
  • Losing Medicaid? You may qualify for subsidized health coverage via Healthcare.gov.

2025 Medicaid Income Eligibility Chart

The Federal Poverty Level (FPL) is used to determine Medicaid eligibility. Each year, the Department of Health and Human Services (HHS) releases new guidelines. Below are the estimated 2025 income limits:

2025 Medicaid Income Limits (100% and 138% of FPL)

Household Size 100% FPL 138% FPL (Medicaid Expansion States)
1 person $14,580 $20,120
2 people $19,720 $27,214
3 people $24,860 $34,307
4 people $30,000 $41,400
5 people $35,140 $48,493
6 people $40,280 $55,586

Note: Some states offer additional state-specific benefits and higher income limits for certain groups.

For more details, visit Medicaid.gov.

Who Qualifies for Medicaid in 2025?

Medicaid eligibility depends on income, household size, and special circumstances. Here’s a breakdown of who may qualify:

1. Medicaid Expansion States

In 38 states and Washington D.C., Medicaid is available to low-income adults (ages 19-64) earning up to 138% of the FPL. These states expanded Medicaid under the Affordable Care Act (ACA).

2. Non-Expansion States

In 12 states, Medicaid is only available to specific populations, including:

  • Pregnant women (usually up to 138%-200% of FPL)
  • Children under 18 (coverage often extends to families earning up to 200%-300% of FPL)
  • Seniors (65+) and disabled individuals (must meet income and asset limits)

3. Special Medicaid Programs

Certain groups may qualify for Medicaid assistance even if they exceed the standard income limits:

  • Medically Needy Programs (for people with high medical bills that lower their income effectively)
  • Long-Term Care Medicaid (covers nursing home costs and in-home care for seniors and disabled individuals)
  • Disability Medicaid (eligibility may be determined based on Social Security Disability Income (SSDI))

To check eligibility, visit your state’s Medicaid office or apply at Healthcare.gov.

Who May Lose Medicaid in 2025?

With the expiration of COVID-19 emergency policies, many people who received temporary Medicaid coverage may now be disqualified based on higher income or changes in household size.

Factors That May Cause Medicaid Loss:

  • Increased income (new job, raises, side income exceeding the threshold)
  • Changes in household size (marriage, divorce, children aging out of coverage)
  • State eligibility updates (some states may introduce stricter income rules)
  • Medicaid Redetermination Process (all states are now reviewing eligibility more strictly)

Tip: If you lose Medicaid, you may qualify for low-cost coverage through the ACA Marketplace at Healthcare.gov.

FAQs On 2025 Medicaid Income Chart

1. How do I apply for Medicaid in 2025?

You can apply online through Medicaid.gov or your state’s Medicaid website.

2. What happens if I make slightly too much money for Medicaid?

If your income is just above the limit, you may qualify for subsidized health insurance plans through Healthcare.gov.

3. Can I qualify for Medicaid if I am unemployed?

Yes, unemployed individuals may qualify if their household income is below the state’s Medicaid threshold.

4. Does Medicaid have asset limits?

For most adults in expansion states, Medicaid does not have an asset limit. However, for seniors and disabled individuals applying for long-term care coverage, asset limits may apply.

5. How often do Medicaid income limits change?

Medicaid income limits are updated annually, based on FPL guidelines.

6. Can I get Medicaid if I have private insurance?

Yes, in some cases, Medicaid can act as secondary insurance to cover additional medical costs.

7. What states have the strictest Medicaid income limits?

As of 2025, Texas, Florida, Alabama, and Georgia have the strictest Medicaid eligibility rules for adults without children.

8. How do I check my Medicaid status?

Visit your state’s Medicaid website or call your local Medicaid office for status updates.