Determining your Income Limit
How to Determine Your Monthly Maximum Income Limit (Family-Related Medicaid)
To determine your monthly maximum income limit, you must first determine:
- Your Medicaid Coverage Group; and
- Your Household Size.
Step 1: Determine Your Coverage Group
Which of these Coverage Groups describes the person applying for Medicaid?
- Parents, Caretakers, Children 19 & 20
- Pregnant Women
- Infants under the age of 1
- Children aged 1 through 5
- Children aged 6 through 18
Step 2: Determine Your Household Size
To determine your Household Size, answer the following questions:
A. Are you a child who is not filing a tax return?
If YES, then your Household Size includes all of these individuals:
- You, and
- Your parents who live in the same household with you (including stepparents and adoptive parents), and
- Your siblings who live in the same household with you and are under 19 or are full-time students under 21. This includes stepsiblings, half-siblings, and adopted siblings.
Proceed to Step 3.
If NO, go to the next question.
B. Will a parent or spouse claim you as a dependent for the current tax year?
If YES, then your Household Size includes all of these individuals:
- You, and
- Your spouse, and
- The individual filing the tax return (also called the tax filer), and
- The tax filer’s spouse, and
- All of the tax filer’s other tax dependents.
Proceed to Step 3.
If NO, go to the next question.
C. Do you expect to file a tax return for the current tax year?
If YES, then your Household Size includes all of these individuals:
- You, and
- Your spouse, and
- Your tax dependents.
Proceed to Step 3.
If NO, then your Household Size includes all of these individuals:
- You, and
- Your spouse, if your spouse lives in the same household with you, and
- Any of your children who live in the same household with you and are under 19 or are full-time students under 21. This includes stepchildren and adopted children.
Step 3: Determine Your Maximum Monthly Income Limit
Once you know your Medicaid Coverage Group and your Household Size, you can use this table to determine your maximum monthly income limit:
Family Related Medicaid Coverage Groups
Size
Age 1
1 to 5
6 to 18
Parents and Caretakers
Women
Effective April 2026
This webpage is provided for general informational purposes only. It does not constitute legal advice and should not be relied upon as a substitute for legal advice or for independent research into applicable law or policy. |