About the Medicaid & CHIP Eligibility Calculator
This Medicaid and CHIP eligibility calculator checks whether your household income falls under your state’s limit for the person you are asking about — an adult, a parent, a pregnant woman or a child. Choose your state, the coverage group and your household size, enter your household’s modified adjusted gross income (MAGI), and it shows your income as a percentage of the 2026 federal poverty level, the state’s Medicaid and CHIP limits in percent and dollars, and the likely result.
It is designed for families deciding whether to apply on their state Medicaid site or HealthCare.gov, for parents checking whether children qualify for CHIP even when the adults do not, and for people in states that have not expanded Medicaid, where adults without children usually cannot qualify on income alone.
State limits come from the CMS Medicaid, CHIP and Basic Health Program eligibility levels table (state choices as of December 1, 2023, the latest CMS edition), and the standard 5-percentage-point MAGI disregard is added, which is why the expansion limit of 133% works out to 138%. States can change their programs, some use dollar amounts for parents, and coverage for people 65+, people with disabilities and long-term care uses different rules — so confirm with your state before deciding.
How to use the medicaid & chip eligibility calculator
- 1Choose your state.
- 2Pick the person you are checking — adult, parent, pregnant woman or child.
- 3Enter your household size (count expected babies for a pregnancy).
- 4Enter yearly household MAGI.
- 5Read the likely result and compare your income with the Medicaid and CHIP limits.
Formula and method
Medicaid and CHIP for children, pregnant women, parents and expansion adults use modified adjusted gross income (MAGI) and tax-household rules. Your yearly MAGI is divided by the 2026 HHS poverty guideline for your household size (Alaska and Hawaii have their own guidelines) to give a percentage of the federal poverty level.
That percentage is compared with your state’s limit for the person’s group from the CMS eligibility-levels table. Federal rules add a disregard equal to 5% of FPL, so a 133% limit becomes 138%. If income is above the Medicaid limit, children and pregnant women are then checked against the state’s separate CHIP limit, and adults in Minnesota and New York against the Basic Health Program limit of 200%.
- MAGI
- Modified adjusted gross income of the household
- FPL
- 2026 HHS poverty guideline for the household size
Worked examples
Single adult in Ohio earning $20,000
Ohio expanded Medicaid, so adults qualify up to 133% + 5% = 138% of poverty, or $22,024.80 for one person. $20,000 is 125.3% of the $15,960 guideline, so the adult is likely eligible.
Child aged 10 in Texas, family of four earning $60,000
Income is 181.8% of the $33,000 guideline. That is above Texas’s 138% Medicaid limit for children 6–18 but under the 206% CHIP limit ($67,980), so the child likely qualifies for CHIP.
Adult without children in Florida earning $12,000
Florida has not expanded Medicaid, so an adult without dependent children has no income-based Medicaid group, even at 75% of poverty. Marketplace subsidies generally start at 100% of poverty.
Pregnant woman in Alaska, household of two, $50,000
Alaska’s 2026 guideline for two people is $27,050, so $50,000 is 184.8% of poverty. Alaska covers pregnant women up to 200% + 5% = 205%, so she likely qualifies.
Frequently asked questions
What is the Medicaid income limit in 2026?+
In states that expanded Medicaid, adults 19–64 qualify with MAGI up to 138% of poverty — about $22,025 a year for one person or $45,540 for a family of four in 2026. Limits for children and pregnant women are higher; non-expansion states have much lower limits for parents.
What is the difference between Medicaid and CHIP?+
Medicaid covers the lowest-income children, parents, pregnant women and (in expansion states) adults. CHIP, the Children’s Health Insurance Program, covers children — and in some states pregnant women — in families that earn too much for Medicaid, often up to 200%–300% of poverty.
What income counts for Medicaid?+
Most groups use modified adjusted gross income: your adjusted gross income from your tax return plus non-taxable Social Security, tax-exempt interest and excluded foreign income. Child support received, SSI and veterans’ disability benefits do not count.
What if my state did not expand Medicaid?+
Adults without dependent children generally cannot get Medicaid on income alone, and parents face very low limits (as low as 12%–30% of poverty in some states). Children and pregnant women can still qualify, and adults above 100% of poverty can get marketplace subsidies.
Does the calculator cover seniors or people with disabilities?+
No. Medicaid for people 65 and older, blind or disabled people and long-term care uses non-MAGI rules with asset tests and different income limits. SSI recipients are usually eligible automatically in most states.
Can I apply for Medicaid at any time of year?+
Yes. Unlike marketplace plans, Medicaid and CHIP have no enrolment period — you can apply any time through your state Medicaid agency or HealthCare.gov, and you must renew your eligibility, usually once a year.
Results are estimates for educational purposes and are not financial advice. Rates, fees and terms vary — confirm with your lender or a licensed advisor before making decisions.