What Medicaid Income Limits Mean for You — and Why They Differ by State

Medicaid income limits are set by each state, not the federal government, so the amount you can earn and still be covered depends on where you live

If you receive Supplemental Security Income (SSI) for a disability, your state's Medicaid income limit is the threshold above which you lose coverage. In most states, that limit is tied directly to the SSI federal benefit rate — currently $943 per month for an individual in 2024, though this amount changes each January. However, some states have set their own higher limits, and a few have set lower ones. The exact number matters because it determines whether you keep Medicaid when your earnings increase or when you receive other income like a pension or settlement.

Income limits also vary by category. If you may have access to for Medicaid through a disability waiver program (like a home and community-based services waiver), your limit may be different from the SSI-linked limit. If you're on Medicaid Expansion in your state, the rules are different again. This section explains what you're actually looking at and how to find your state's specific number.

Key Takeaways

• Most states tie their Medicaid income limit for people receiving SSI to the federal SSI benefit rate, which is $943 monthly for an individual in 2024, but some states have set higher or lower limits.
• Your state's Medicaid office or your case manager can tell you the exact income limit that applies to your category — SSI-linked, waiver, or Expansion — because limits differ by program.
• Income includes wages, pensions, Social Security, rental income, and some gifts, but does not include certain work incentives like Plans to Achieve Self-Support (PASS) or Impairment Related Work Expenses (IRWE).
• If your income rises above the limit, you may lose Medicaid immediately or at the end of the month, depending on your state's rules, so reporting changes quickly protects your coverage.

How states set their own limits

The federal government sets the SSI benefit rate, but it does not set Medicaid income limits. Each state legislature decides how much income a person can have and still receive Medicaid. Most states have chosen to use the SSI rate as their limit — meaning if you receive SSI, your Medicaid income limit is $943 per month (for 2024). This is sometimes called the "SSI-related" limit.

However, about a dozen states have set their limits higher than the SSI rate. These are called "Section 1634 states" or "SSI-related but higher" states. For example, some set the limit at 75% or 100% of the federal poverty level, which is higher than the SSI rate. A very small number of states have set limits lower than SSI, though this is rare. Your state's Medicaid program website or your case manager can tell you which category your state falls into and what your specific limit is.

The limit also depends on your family size if you have dependents, and on which Medicaid program you're in. If you're on a waiver program, the income limit may be higher than the SSI-related limit. If you're on Medicaid Expansion (available in most but not all states), the limit is usually based on a percentage of the federal poverty level, not on SSI at all.

What counts as income and what doesn't

Income includes money you earn from work, Social Security benefits, pensions, rental income, and some gifts or support from family members. It also includes unemployment benefits and workers' compensation. The key is that Medicaid counts almost any regular money coming in, whether it's from employment or not.

However, certain work-related income does not count toward your limit. If you use a Plan to Achieve Self-Support (PASS), you can set aside money you earn toward a specific work goal, and that money doesn't count. If you have Impairment Related Work Expenses (IRWE) — costs you must pay because of your disability to be able to work — those expenses reduce your countable income. Some states also exclude a small amount of unearned income (like interest) or allow a small monthly work incentive exclusion. Your state's Medicaid office can tell you which exclusions apply to you.

The difference matters. If you earn $1,000 per month but $200 of that goes to IRWE, your countable income is $800, which may keep you under the limit. Reporting these exclusions to your caseworker is essential, because Medicaid staff do not always calculate them automatically.

State-by-state income limits: what to look for

Rather than listing every state's limit here (which changes annually and varies by program), the most reliable way to find your number is to contact your state's Medicaid office directly. You can reach them through your state's health department website or by calling 211, which connects you to local benefits information. Have your state name and your disability category ready — SSI-related, waiver, or Expansion — so they can give you the right figure.

You can also ask your case manager or Social Security representative. If you receive SSI, your Social Security office has a relationship with your state's Medicaid program and can often tell you the income limit or direct you to the right office. If you're on a waiver program, your waiver case manager should know your specific limit and should review it with you annually.

When you contact your state, ask not just for the dollar amount but also for the date it takes effect (usually January 1 each year) and whether it changes if you have dependents. Write down the name of the person who tells you and the date, in case you need to refer back to it later.

What happens when your income goes above the limit

If your income rises above your state's limit, you will lose Medicaid coverage. The timing depends on your state. Some states end coverage at the end of the month in which you go over the limit. Others end it immediately. A few allow a grace period of one or two months. Your state's Medicaid office should tell you the exact timing when you report the income change.

This is why reporting changes quickly matters. If you start a job or receive a raise, contact your Medicaid caseworker right away. Do not wait for your next scheduled review. The sooner you report, the sooner your caseworker can tell you whether you'll lose coverage and when, so you can plan. Some states have work incentive programs that can help you keep Medicaid even when you're earning, but you have to ask about them and enroll before your income goes over the limit.

If you lose Medicaid because your income is too high, you may be able to get it back if your income drops again. The process for reapplying varies by state — some allow you to reapply immediately, others require you to wait a certain period. Ask your caseworker what the process is in your state before you lose coverage, so you know what to do if your circumstances change.

Work incentives that can protect your Medicaid

If you're working or thinking about working, several federal work incentives can help you keep Medicaid even when your earnings would normally put you over the limit. The most common are PASS and IRWE, mentioned above. Another is the Student Earned Income Exclusion, which excludes some earnings if you're a student under age 22. There's also the Impairment Related Work Expenses exclusion for costs directly related to your disability.

These programs require you to set them up in advance, usually with your Social Security representative or your state Medicaid office. You cannot use them retroactively. If you're planning to work or increase your hours, contact your Social Security work incentives planning and assistance (WIPA) project or your state's Protection and Advocacy for Beneficiaries of Social Security (PABSS) program. Both are free and can help you understand which incentives apply to your situation and how to set them up before your income changes.

Frequently Asked Questions

Does my income limit change every year?

Yes. Most states adjust their income limits on January 1 each year to match the new SSI federal benefit rate. If your state uses a percentage of the federal poverty level instead, that limit also changes annually. Your caseworker should notify you of the change, but you can also call your state Medicaid office in December to confirm the new limit.

If I'm married, does my spouse's income count toward my limit?

It depends on your state and your Medicaid category. For SSI-related Medicaid, spousal income usually does not count if you and your spouse file separate tax returns and your spouse is not receiving SSI. However, rules vary, and some states count it differently. Ask your caseworker specifically whether your spouse's income affects your Medicaid limit.

What if I disagree with my state's income limit calculation?

You have the right to request a fair hearing through your state's Medicaid office. If you believe your income was calculated incorrectly or that you may have access to for an exclusion your caseworker did not apply, you can file a hearing request. Contact your state Medicaid office or a legal aid organization in your state for help with the process.

Can I keep Medicaid if I go back to school and stop working?

Yes. If your income drops below the limit, you can report the change and keep or regain Medicaid. However, if you're receiving student financial aid, some of that aid may count as income. Ask your caseworker whether your specific aid package will affect your Medicaid before you enroll.

What's the difference between my income limit and my resource limit?

Income is money coming in each month. Resources are things you own — savings, a car, property. Medicaid has both an income limit and a resource limit. For SSI-related Medicaid, the resource limit is usually $2,000 for an individual. You can have income above the limit and still lose Medicaid, or you can have resources above the limit and lose coverage. Ask your caseworker about both limits for your category.