What Income Counts When You're Pregnant and Applying for Medicaid

How Medicaid income limits work for pregnant people

Medicaid income limits for pregnant people are set by each state, not by the federal government, so the threshold where you stop being covered depends entirely on where you live. Most states use a percentage of the Federal Poverty Level (FPL) — a number the government updates every year — to decide who gets coverage. A state might say "we cover pregnant people up to 200% of FPL," which means your household income can be double the poverty line and you still may have access to.

The actual dollar amount changes every January when the poverty line updates. In 2024, for example, 100% of FPL for a single person was around $14,600 per year, but that number shifts annually. Because states set their own limits, a pregnant person in one state might be covered at an income level that disqualifies someone in a neighboring state.

When you apply, the program counts your household income — not just your own earnings. That usually means your spouse's income if you're married, your parents' income if you're under 19 and they claim you as a dependent, and sometimes income from other household members depending on your state's rules. Self-employment income, child support, and Social Security all count.

Key Takeaways

• Each state sets its own income limit for pregnant people, ranging from around 138% to 380% of the Federal Poverty Level depending on where you live.
• The dollar amount of the income limit changes every January when the federal poverty line updates, so last year's number may not apply to your current application.
• Your household income — including your spouse's earnings, child support, and self-employment — is what counts, not just your own paycheck.
• You can find your state's exact limit and apply through your state Medicaid office, your local health department, or a community health center.

State-by-state income limits: what varies and why

States fall into roughly three groups based on how generous their income limits are. Some states — mostly in the South and Midwest — cover pregnant people up to around 138% to 150% of FPL, which is the federal minimum. Other states, particularly in the Northeast and West Coast, cover up to 200% to 250% of FPL. A smaller group of states, including New York and California, go as high as 300% to 380% of FPL, meaning a pregnant person with a much higher income can still be covered.

The reason for this variation is that states can choose to expand Medicaid beyond the federal minimum. Some states decided to do this for pregnant people specifically, even if they didn't expand for other groups. This means your coverage options depend on a state policy choice, not on a federal rule that applies everywhere.

Because these limits change annually and occasionally shift when state legislatures pass new laws, the most reliable way to find your state's current limit is to contact your state Medicaid office directly or visit your state's Medicaid website. A community health center or local health department can also tell you the current number and help you understand whether your household income falls within it.

How to find your state's specific income limit

Start by going to your state's Medicaid website — search "[your state] Medicaid" plus "pregnant women" or "pregnancy." Most state sites have a page that lists the income limit in dollars per month or per year, along with household size. If the website doesn't clearly state the number, call your state Medicaid office's main line and ask for the current income limit for pregnant people. Have your household size ready when you call, because the limit changes based on how many people live with you.

If you're having trouble reaching your state office, try calling 211 (a free referral service) or visiting a Planned Parenthood health center, community health center, or local health department. Staff at these places work with Medicaid daily and can tell you whether your income falls within your state's limit. They can also help you start the application process if you do.

Write down the exact limit and the date you found it, because you'll need to reference it when you apply. If your income is close to the cutoff, ask the program whether they count gross income (before taxes) or net income (after taxes), because that can make a difference of several hundred dollars.

What happens if your income is just above the limit

If your household income is slightly above your state's limit, you have a few options. First, check whether your state counts income differently than you expect — some states exclude certain types of income, or allow deductions for child care or medical expenses, which can lower your countable income enough to bring you under the limit. Ask the Medicaid office specifically what deductions or exclusions they allow.

Second, if you're self-employed or have irregular income, you may be able to average your income over several months, which sometimes brings you under the threshold. Third, some states have separate programs for pregnant people with higher incomes, though these are less common and usually have higher cost-sharing (copays and deductibles).

If none of these apply and you're genuinely over the limit, you can still look into marketplace insurance through Healthcare.gov, which may be more affordable than private insurance and sometimes offers subsidies based on your income. A community health center can help you compare options.

Income limits for different household sizes

Medicaid income limits are always stated as a percentage of the Federal Poverty Level, and the dollar amount of that level depends on your household size. A single person has a lower poverty line than a family of four, so the income limit for a pregnant person living alone is lower than the income limit for a pregnant person with a spouse and two children.

When you apply, you'll need to tell the program how many people live in your household and whether anyone else has income. The program will then calculate whether your total household income falls within the limit for your household size. If you're not sure who counts as part of your household, the Medicaid office can clarify — it usually includes people who live with you and share expenses, but the exact definition varies slightly by state.

How income is counted: what to include and what to report

When you apply for Medicaid as a pregnant person, report all income your household receives. This includes wages from a job, self-employment income, child support or alimony, Social Security, unemployment benefits, and money from a roommate or family member who lives with you and contributes to household expenses. Some states also count student loans as income if you're receiving them, though this varies.

You'll usually need to provide recent pay stubs (typically the last two months), a tax return from the previous year, and proof of any other income. If your income is irregular — you work seasonal jobs or freelance — bring documentation showing what you typically earn over a year. The program will use this to estimate your annual income and compare it to the limit.

Be honest about what you earn. If you underreport income and are later found to have done so intentionally, you could be asked to repay benefits. If your income genuinely varies month to month, tell the Medicaid office that when you apply — they have methods for handling variable income that are fairer than just looking at one month.

What to do if your income changes after you're covered

If you're already covered by Medicaid for pregnancy and your income goes up, you're usually allowed to stay covered through the end of your pregnancy and for 60 days after you give birth, even if your new income is above the limit. This protection is called continuous coverage for pregnant and postpartum people, and it exists specifically so you don't lose coverage in the middle of pregnancy because of a job change or raise.

After the 60-day postpartum period ends, your coverage will be reviewed based on your current income. If you're still above the limit at that point, you'll lose Medicaid coverage unless your state has a separate program for people with higher incomes. This is why it's important to know what your coverage options will be after pregnancy — talk to your health center or Medicaid office about this before your postpartum coverage ends.

If your income goes down after you're covered, report it to Medicaid. Your coverage won't change, but the program needs accurate information for its records.

Frequently Asked Questions

Does my spouse's income count if we're not married but live together?

It depends on your state. Most states count the income of anyone in your household who is related to you or your child, but some states have different rules for unmarried partners. Call your state Medicaid office and describe your household situation — they can tell you exactly who counts as part of your household for income purposes.

What if I'm a teenager living with my parents — do their income count?

Yes, if you're under 19 and your parents claim you as a dependent on their taxes, their income counts as part of your household income. If you're 19 or older, only your own income and your spouse's income (if you have one) count, even if you live with your parents. Some states have different rules, so confirm with your state Medicaid office.

Can I be covered if I'm undocumented?

Most states cover pregnant people regardless of immigration status, because federal law allows states to use their own money (not federal Medicaid dollars) to cover undocumented immigrants. However, the rules vary by state. Contact your state Medicaid office or a community health center — they can tell you whether you're covered and help you apply without asking about immigration status in a way that puts you at risk.

What if my income is seasonal — how do they calculate it?

If you work seasonal jobs or have irregular income, Medicaid typically averages your income over the past 12 months or projects your income for the next 12 months, rather than just looking at one month. Bring documentation of your typical earnings — tax returns, pay stubs from different seasons, or a letter from your employer explaining your income pattern — and tell the program that your income varies.

Do I have to report tips or cash income?

Yes. All income counts, including tips, cash payments, and informal work. Medicaid programs are required to count all income you receive, and underreporting can result in being asked to repay benefits. If you're worried about how to document cash income, ask the Medicaid office what proof they accept — sometimes a signed statement from your employer is enough.