MAGI Medicaid
The Medicaid eligibility rules used for most adults under 65, kids, pregnant people, and parents — based on tax income.
MAGI Medicaid uses Modified Adjusted Gross Income — based on your federal tax return — to decide eligibility for most non-elderly, non-disabled Medicaid groups. The Affordable Care Act standardized MAGI rules so that eligibility for adults under 65, children, pregnant people, and parents follows a single income definition across all states. MAGI does not count assets like savings or a car, which is a major difference from non-MAGI Medicaid (used for older adults, people with disabilities, and long-term care). Income limits are set as a percentage of the Federal Poverty Level (FPL); in most expansion states adults are covered up to 138% FPL, while children and pregnant people are usually covered at higher levels (often up to 200% FPL or more). Households apply through the state Medicaid agency or Healthcare.gov, and eligibility is rechecked at least once a year. People who lose MAGI Medicaid often qualify for Marketplace subsidies.
In real life
- A young parent earning 130% FPL qualifies for MAGI Medicaid in an expansion state.
- A pregnant person with income at 180% FPL is covered under her state's MAGI Medicaid for pregnancy.
- A worker who loses Medicaid at renewal because his income rose qualifies for ACA subsidies.
Also known as
Frequently asked questions about MAGI Medicaid
Are assets counted under MAGI Medicaid?+
No. Only income from your tax return is counted.
What about long-term care?+
Long-term care uses non-MAGI rules with asset limits. MAGI does not apply there.
Where do I apply?+
At your state Medicaid agency or Healthcare.gov, which routes you to Medicaid if eligible.
How often is eligibility checked?+
At least once every 12 months.
Source: medicaid.gov