Do I Qualify for Medicaid? Free 2026 Eligibility Calculator
Figures last verified against SSA.gov and Medicaid.gov in September 2026.
Medicaid Eligibility Calculator — 2026
Enter your state, household size, monthly income, and countable assets below. Results appear instantly — no sign-in required.
California, Arizona, New York, and Illinois have different rules — the calculator adjusts automatically.
Include Social Security, pension, wages, rental income. Enter the gross (full) amount before Medicare premium deductions.
Include: checking, savings, CDs, stocks, bonds, second properties.
Do NOT include: your primary home, one vehicle, household belongings, prepaid burial funds under $1,500, or life insurance face value under $1,500.
| What We Checked | Your Number | 2026 Limit | Status |
|---|
No Account. No Sign Up.
Use the tool instantly — no email, no password, nothing to create.
We Never Sell Your Data.
Your inputs are used only to generate your result. We do not share, store, or sell any information you enter.
Fully Independent.
Seniors Audit is not affiliated with any insurance company, government agency, or data broker. We have no financial interest in your coverage choices.
Why We Built This Independent Calculator
We built this tool because most people facing a Medicaid question get sent to a 40-page PDF or a state website that assumes they already know the rules. That is not helpful when someone is staring at a nursing home invoice or managing a parent's finances from across the country. This calculator puts the actual federal numbers in front of you in under two minutes, flags where your state's rules differ, and tells you exactly where to go next — with nothing sold to you at any point.
- Adults 60 or older on a fixed income who want to know whether their monthly income and savings fall under the Medicaid thresholds
- Adult children managing a parent's health decisions who need a fast first check before consulting a state Medicaid office
- Anyone recently widowed, disabled, or facing a health crisis who needs to understand their coverage options before the next doctor's appointment
How to Use This Calculator — Five Steps
- Step 1 — Select your state. The calculator checks your state code and automatically adjusts the asset-limit logic. California and Arizona residents will see an immediate note that no asset test applies in their state. New York and Illinois residents will see the higher state-specific thresholds instead of the federal floor.
- Step 2 — Choose individual or couple. Medicaid applies separate income and asset limits depending on whether you are applying alone or as a married couple. Both must be correctly selected for the numbers to reflect your actual situation.
- Step 3 — Enter your total monthly gross income. Add together every source of monthly income before any deductions: Social Security retirement benefit (the full gross amount, before Medicare Part B premium deductions), pension, wages, rental income, VA non-service-connected pensions. Do not subtract taxes or Medicare premiums — enter the full gross number.
- Step 4 — Enter your countable assets. Add the balances in your checking accounts, savings accounts, money market accounts, CDs, and any investment or brokerage accounts. Add the value of any property other than your primary home. Do not include your home, one vehicle, household goods, burial funds under $1,500, or life insurance cash value under $1,500 — these are typically exempt.
- Step 5 — Read your result. The result block shows your specific verdict and displays a table comparing your numbers to the applicable thresholds. The "Next Step" link goes directly to your state Medicaid office. If you want free one-on-one help understanding your result, a SHIP counselor can walk through it with you at no cost.
State Variation Matters More Than Most Calculators Admit
This calculator uses the federal SSI-based figures as its default because they represent the most widely applicable baseline. But Medicaid is a state-federal partnership, and the exact rules can differ in ways that are material, not just technical. If you live in a state that uses 100% FPL ($1,330) rather than the SSI rate ($994) as its income threshold, the federal-default result may read "likely not eligible" when your state's actual answer is "likely eligible." Verifying with your state's own Medicaid agency is not optional; it is the only source of a final answer. Use the USA.gov Medicaid finder to locate your state's official application portal.
What This Looks Like in Real Life — Three Scenarios
These examples are based on the 2026 federal figures and verified state rules described above. They are illustrative, not advice. Your actual eligibility will be determined by your state Medicaid office.
Margaret receives $890/month from Social Security and has $1,600 in a savings account. She owns her home and a used car.
Her monthly income ($890) falls below Texas's $994 SSI-based threshold. Her countable assets ($1,600) fall below the $2,000 federal asset limit. Her home and vehicle are not counted. She qualifies for ABD Medicaid under the federal baseline that Texas follows. Her next step is applying through the Texas Health and Human Services Commission (hhs.texas.gov). She should also check our Medicare Savings Program Estimator — at her income level she likely qualifies for help with her Medicare premiums too.
Rosa lives in Los Angeles. She receives $1,050/month in Social Security and has $28,000 in a CD that she has been afraid disqualifies her. Under California's Medi-Cal rules, no asset test applies to the ABD pathway.
| Factor | Rosa's Number | California Rule | Status |
|---|---|---|---|
| Monthly income | $1,050 | 100% FPL: $1,330 | ✓ Under limit |
| Savings / assets | $28,000 | No test applies | ✓ Not counted |
Rosa qualifies for Medi-Cal. Her $28,000 in savings does not affect her eligibility at all. She had avoided applying for two years, costing her thousands in out-of-pocket medical bills. Her next step is applying through the California Department of Health Care Services (dhcs.ca.gov) or her county DHCS office. Because she also has Medicare, she should check our Extra Help eligibility calculator for prescription drug cost assistance.
Frank and Helen have a combined Social Security income of $1,540/month. They have $3,400 in a joint savings account. Ohio uses the federal SSI-based couple limit of $1,491 income and $3,000 assets.
Their combined income ($1,540) is $49 over the couple's SSI threshold of $1,491. Their assets ($3,400) are $400 over the $3,000 couple limit. However, Ohio — like most states — applies a $20 monthly income disregard, reducing their "countable" income to $1,520, still slightly over. They should contact their local county Job and Family Services office or a free SHIP counselor (shiphelp.org) to verify whether any additional disregards reduce their countable income below the threshold, and whether a small spend-down on medical bills would bring their assets in range.
Common Mistakes That Cause People to Miss Out
Assuming the $2,000 Asset Limit Applies in Every State
The $2,000 individual asset limit is the federal SSI floor, the minimum standard set by federal law. Many states use higher limits, and California and Arizona have eliminated the asset test entirely. KFF's 2026 state-by-state Medicaid eligibility table shows which states diverge from the federal floor. Do not assume you are disqualified based on savings until you have checked your state's actual rule.
Counting Exempt Assets as Countable
Your primary home and the land it sits on, one vehicle of any value, household furniture and appliances, burial insurance with face value under $1,500, and term life insurance with no cash value are all typically excluded from the asset count. Many families who think they own "too much" are actually well within their state's countable asset limit once exemptions are correctly applied. Read our guide on who qualifies for Medicaid for a full breakdown of countable versus exempt assets.
Confusing the ABD Income Threshold with the Nursing Home Income Cap
The $994/month SSI-based income limit covers community-based (non-institutional) Medicaid. For nursing home Medicaid specifically, many states use a higher income cap equal to 300% of the SSI Federal Benefit Rate. In 2026, that cap is $2,982/month. Exceeding that number does not automatically disqualify you; it triggers the requirement for a Qualified Income Trust. These are two different rules for two different situations. If nursing home coverage is your focus, pair this tool with our care facility cost comparison tool.
Not Applying Because Income Is Slightly Over the Threshold
Standard income disregards, including the $20/month general disregard most states apply, can lower your "countable" income below the threshold even when your gross income appears over it. Someone receiving $1,010/month looks $16 over the $994 limit on paper. After the $20 disregard, their countable income is $990, which is under the limit. Always submit the application and let your state Medicaid office run the formal calculation before you decide you do not qualify.
Believing Medicare Already Covers Everything
Medicare does not cover long-term nursing home care beyond 100 days, most dental, vision, hearing aids, or personal care services. Medicaid fills those gaps for people who qualify. Checking your Medicaid eligibility is not redundant with having Medicare. For many older adults, both programs work side by side and together cover far more than either does alone. Read our guide on having Medicare and Medicaid at the same time.
Understanding the Aged, Blind & Disabled Medicaid Pathway
There are multiple Medicaid pathways in the United States. This calculator covers the Aged, Blind & Disabled (ABD) pathway, which applies to people 65 or older and to people under 65 with a qualifying disability. Below is how the system works and what the official rules actually say.
What the ABD Pathway Covers
ABD Medicaid (authorized under 42 U.S.C. § 1396a) pays for services that Medicare either skips entirely or covers only partially. That list includes: long-term nursing home care after Medicare's 100-day limit, personal care attendant services, adult day health programs, dental, vision, hearing aids, and medical transportation. In many states, Medicaid is the only program willing to cover extended nursing home stays. See our Long-Term Care Savings Runway Calculator to see how long your savings could last before Medicaid would need to step in.
ABD Medicaid is not a Medicare supplement. It does not replace Medicare for hospital or physician services. People enrolled in both programs (called "dual eligible" beneficiaries) use Medicare first, and Medicaid covers what remains. Read our guide on having Medicare and Medicaid at the same time for a full explanation.
How the Spend-Down Process Works
Being modestly over the income or asset limit does not automatically disqualify you. You may qualify through a Medicaid spend-down, which works like a medical deductible. You must spend a set amount on medical bills before Medicaid coverage activates for the rest of the month. That amount equals the difference between your income and the state threshold.
Here is a concrete example: if your state limit is $994 and you receive $1,050/month, your monthly spend-down is $56. Once you have $56 in qualifying bills (copays, prescriptions, Medicare premiums), Medicaid covers remaining costs. You are not writing a $56 check; those bills are credited against the spend-down obligation.
Not every state offers spend-down. States with strict income caps require a Qualified Income Trust (QIT), also called a Miller Trust, when income exceeds the cap. A QIT routes part of your monthly income into a restricted trust account, lowering your countable income below the threshold. Your state SHIP counselor or an elder law attorney can walk you through setting one up.
The 5-Year Lookback: What It Covers and What It Does Not
Many families worry about the Medicaid 5-year lookback rule. The good news is that this rule applies only in specific circumstances, not across the board.
The 60-month lookback period, established by the Deficit Reduction Act of 2005, applies only to nursing home Medicaid. Community-based ABD Medicaid (the pathway this calculator covers) generally has no lookback on asset transfers.
For nursing home Medicaid specifically: if you transferred assets below fair market value within the previous 60 months (gifting money to children, signing over your house, or making large donations), Medicaid may impose a penalty period with no coverage. The penalty is calculated by dividing the transferred amount by your state's average private nursing home daily rate. Our Long-Term Care Savings Runway Calculator can help you model those costs in advance.
Before any large asset transfer, speak with a SHIP counselor or an elder law attorney. Getting this wrong can result in a penalty period lasting months with no nursing home coverage at all.
Dual Eligibility: Having Both Medicare and Medicaid
More than 12 million Americans carry both Medicare and Medicaid. For these "dual eligible" beneficiaries, Medicare pays first for hospital and physician services. Medicaid then covers costs Medicare does not, including premiums, deductibles, copays, and long-term care. The CMS Medicare-Medicaid Coordination Office oversees how the two programs work together.
Dual eligibility comes in different tiers. Qualified Medicare Beneficiaries (QMB) receive full Medicare cost-sharing coverage through Medicaid. Specified Low-Income Medicare Beneficiaries (SLMB) get their Part B premium paid. Both tiers are administered by your state Medicaid office. Use our Medicare Savings Program Estimator to find which tier you may qualify for. Qualifying for full Medicaid almost always means you qualify for at least one MSP tier as well.
What Happens After You Submit Your Application
Once you apply, your state Medicaid agency has a federally mandated decision window. Under 42 CFR § 435.912, standard eligibility decisions must be made within 45 days. Disability-related determinations get up to 90 days. During the review, expect requests for documentation: income verification (Social Security award letter, pension statements), bank statements, proof of residence, and sometimes a physician statement.
If your application is approved, coverage can be backdated to your application date or, in some states, up to three months before you applied. That means medical expenses from the waiting period may be reimbursed. Use the USA.gov Medicaid finder to locate your state's application portal.
Free Help Is Available: SHIP Counselors Work at No Cost
Every state funds a State Health Insurance Assistance Program (SHIP). SHIP counselors are trained volunteers, not insurance agents and not commission-based. They can review your income and assets, explain your state's specific rules, and walk you through the application. The service costs nothing. Find your local counselor at shiphelp.org or call 1-877-839-2675. While you are at it, check whether you also qualify for food assistance using our SNAP Eligibility Calculator for Seniors.
Official Sources Used in This Calculator
| Source | Type | What We Used It For | Direct Link |
|---|---|---|---|
| SSA — SSI Federal Payment Amounts 2026 | Federal Government | SSI Federal Benefit Rate: $994/month (individual), $1,491/month (couple). Asset limits: $2,000/$3,000. These are the default income and asset thresholds used for the ABD Medicaid calculation in most states. | ssa.gov/oact/cola/SSI.html |
| SSA — SSI Redbook 2026 | Federal Government | Supplemental figures on SSI benefit rates and the relationship between SSI limits and state Medicaid programs. | ssa.gov/redbook/newfor2026.htm |
| Medicaid.gov — Eligibility Guidance | Federal Government | Aged, Blind & Disabled Medicaid pathway rules, including the 42 U.S.C. § 1396a federal statutory framework. | medicaid.gov |
| KFF — Non-MAGI Medicaid Eligibility Levels 2026 | Research Organization (not a government source) | Cross-reference data for state-by-state income and asset limit variations, particularly for states using 100% FPL rather than the SSI rate as their income threshold. KFF is an independent health policy research organization; their figures were used for general cross-referencing only. All state-specific figures were verified against state agency sources before use. | kff.org — Medicaid Eligibility Levels |
Seniors Audit is an independent educational platform. We are not affiliated with, endorsed by, or connected to any government agency, insurance company, or financial services firm. We do not receive payment for referrals or any action taken by visitors.
Frequently Asked Questions About Medicaid Eligibility
Does my house count toward the Medicaid asset limit?
No. Your primary home — the one you live in — is not counted toward the Medicaid asset limit under the Aged, Blind & Disabled (ABD) pathway. One vehicle, household furniture and appliances, prepaid burial arrangements, and life insurance policies with a face value under $1,500 per person are also typically excluded. Only accounts, savings, investments, and second properties generally count as "countable" assets.
What counts as income for Medicaid eligibility purposes?
Countable income under the ABD Medicaid pathway typically includes: Social Security retirement and SSDI benefits, pension payments, wages and self-employment income, rental income, annuity payments, and VA benefits (with certain exclusions). Items that are generally not counted include the first $20 of most monthly income and certain irregular small gifts. However, what counts varies by state — your state Medicaid office applies its own specific income disregards.
Is the Medicaid asset limit different in every state?
Yes. The federal SSI baseline is $2,000 for an individual and $3,000 for a couple, but many states have higher limits or no asset test at all. California and Arizona currently have no asset test for this pathway. New York's limit is substantially higher than the federal floor — approximately $32,000 or more for an individual. Illinois uses approximately $17,500. For all other states, verify your exact limit directly with your state Medicaid agency.
What is the SSI Federal Benefit Rate and why does it matter for Medicaid?
The SSI Federal Benefit Rate (FBR) is the standard monthly income amount the Social Security Administration sets for the Supplemental Security Income program. In 2026, it is $994/month for an individual and $1,491/month for a couple. For the Aged, Blind & Disabled Medicaid pathway, many states use this same number as their income threshold for eligibility, making it the most widely applicable benchmark for this type of Medicaid across the country.
Can you have Medicare and Medicaid at the same time?
Yes. People who qualify for both programs are called "Dual Eligible" beneficiaries. Medicare covers hospital and medical services while Medicaid can cover what Medicare does not, including long-term care, dental, vision, and cost-sharing. For a full explanation of how both programs work together, see our guide on having Medicare and Medicaid simultaneously.
What is the income limit for nursing home Medicaid in 2026?
For nursing home or institutional-level Medicaid, many states use an income cap equal to 300% of the SSI Federal Benefit Rate. In 2026, that equals $2,982/month for an individual. If your income exceeds this number, you may still qualify through a "spend-down" or a Qualified Income Trust (QIT/Miller Trust) in income-cap states. This income cap does not apply to community-based Medicaid — check which rules apply to your situation with your state Medicaid office.
What happens if my income is slightly over the Medicaid limit?
You may still qualify through a Medicaid spend-down process, which works similarly to a medical deductible. You must spend money on medical expenses until your remaining income drops below the threshold, at which point Medicaid covers remaining costs. Not all states offer spend-down; some use income-cap rules instead. Contact your state Medicaid office directly to find out which applies to you.
How do I apply for Medicaid under the Aged, Blind & Disabled pathway?
Apply through your state Medicaid agency — not through Social Security or Medicare directly. Visit usa.gov/medicaid-chip-insurance to find your state's application portal or phone number. You can also apply in person at your local Department of Social Services office. Have proof of income (Social Security award letter, pension statements), proof of identity, and bank account statements ready before you begin.
Does California really have no asset test for Medicaid?
Correct. California (Medi-Cal) eliminated the asset test for the ABD Medicaid pathway as part of its 2022 reform. Eligibility in California is determined solely by income. The income limit for an individual is based on 100% of the Federal Poverty Level ($1,330/month in 2026) rather than the SSI rate. Always confirm the current rule directly with the California Department of Health Care Services, as this policy was legislated and could be subject to future changes.
What is the difference between Medicaid and the Medicare Savings Program?
Full Medicaid (ABD pathway) is a comprehensive health coverage program that can pay for long-term care, dental, and services Medicare does not cover. The Medicare Savings Program (MSP) is a subset of Medicaid that only helps pay Medicare premiums, deductibles, and copays. They are administered by the same state Medicaid office, but they are different programs with different income limits. Qualifying for full Medicaid often (but not always) also qualifies you for an MSP.
Other Free Tools That May Help You
For the full explanation of how the Aged, Blind & Disabled pathway works — including the federal legal framework — read our guide on who qualifies for Medicaid. If you are wondering how recent federal budget changes may have affected eligibility rules in your state, see our coverage of Medicaid changes in 2026. Many Medicaid-eligible seniors are also simultaneously eligible for Medicare — our guide on having Medicare and Medicaid at the same time explains how both programs work together. If your Medicaid application is specifically for nursing home coverage, use our care facility cost comparison tool alongside this calculator.
About This Educational Estimate: This tool is for educational purposes only. Seniors Audit uses the official formulas published by Medicaid.gov / Centers for Medicare & Medicaid Services, but results are estimates based on the information you entered. Rules, rates, and eligibility thresholds change annually and vary by individual circumstance.
Always verify your specific result directly with Medicaid.gov / Centers for Medicare & Medicaid Services at 1-800-633-4227 or at www.medicaid.gov before making enrollment, coverage, or financial decisions.
If you have Medicare questions, a free SHIP counselor in your state can review your specific situation at no cost — find yours at shiphelp.org.
Seniors Audit is independent and not affiliated with any government agency or insurance company. We are not affiliated with, endorsed by, or connected to any government agency, insurance company, or financial services firm. All calculations use the official formulas and current figures published by the agencies listed above. We do not receive payment for referrals, leads, or any action taken by visitors to this site. Last reviewed: September 2026.