Medicaid Income Limits NY 2025: Who Qualifies and How

If you're a New York resident trying to understand your Medicaid eligibility in 2025, you're not alone. Each year, New York State adjusts its income and asset limits for Medicaid applicants to reflect inflation and policy changes—and those adjustments can directly impact whether you or a loved one can receive low-cost or no-cost healthcare coverage.

In this guide, we’ll break down the Medicaid income limits in NY for 2025, explain how different rules apply to adults, families, seniors, and individuals with disabilities, and answer some of the most frequently asked questions people have when applying or reapplying for coverage.

What are the 2025 Medicaid income limits in New York?

The Medicaid income limits in New York are set based on Modified Adjusted Gross Income (MAGI) for most applicants under 65 without Medicare. These limits are tied to the Federal Poverty Level (FPL) and adjusted annually.

Here are the updated monthly income limits for 2025:

• Single adult (age 21–64): $1,799.75/month

• Married couple: $2,433/month

• Family of three: $3,068/month

• Family of four: $3,708/month

These figures are used to determine eligibility for what’s commonly referred to as Community Medicaid (i.e., coverage for people living at home, not in nursing facilities).

Do seniors and people with disabilities have different limits?

Yes. If you’re 65 or older, blind, or living with a disability—and receiving or eligible for Medicare—you fall under non-MAGI Medicaid rules. These income limits are slightly different and often include an asset/resource test.

For 2025:

• Single applicant (aged, blind, disabled):

  • Monthly income limit: $1,799.75

  • Asset/resource limit: $32,396

• Married couple:

  • Monthly income limit: $2,433

  • Asset/resource limit: $43,781

Importantly, New York eliminated the asset test for many non-institutional applicants in 2024, and that change remains in place for 2025. However, if you're applying for Institutional Medicaid (like nursing home care), asset limits and income caps still apply—along with strict documentation requirements.

What counts as income (and what doesn’t)?

When evaluating eligibility, Medicaid considers your gross monthly income from a wide range of sources:

Countable income includes:

• Wages from a job

• Social Security benefits

• Retirement or pension payments

• Unemployment compensation

• Rental income

• Capital gains

Generally excluded income includes:

• Supplemental Security Income (SSI)

• Certain veterans’ benefits

• Child support received (for MAGI applicants)

For applicants under the MAGI system, Medicaid uses Modified Adjusted Gross Income—which includes your adjusted gross income (AGI) plus certain deductions like non-taxable Social Security.

What if my income is too high?

Even if your income exceeds the Medicaid limit, you may still qualify through spend-down or other financial planning tools.

Options include:

• Medicaid Spend-Down (Medically Needy Program)
  If your medical expenses reduce your income below the eligibility threshold, you can qualify. You’ll pay those excess costs yourself—similar to meeting a deductible—and Medicaid will cover the rest once you’ve “spent down” enough.

• Pooled Income Trusts
  For people with disabilities, income above the Medicaid limit can be deposited into a pooled income trust, which shelters it from eligibility calculations while allowing it to be used for rent, utilities, or other approved expenses.

• Asset Spend-Down
  If you exceed asset limits (for institutional care), you may qualify by spending down excess assets on legitimate needs such as home repairs, prepaid burial arrangements, or paying off debt.

How do I apply and report changes?

To apply for Medicaid in New York, you can go through the New York State of Health Marketplace or directly contact your local Department of Social Services (LDSS)—especially if you're over 65 or applying for long-term care Medicaid.

Helpful tips:

• Apply early to avoid coverage gaps.

• Report income and household changes within 30 days.

• Recertify annually, even if nothing changes.

Also, New York offers continuous coverage for pregnant individuals (12 months postpartum) and protection from mid-year eligibility loss if your income increases slightly during that time.

Can teens or students earn income without risking Medicaid for the family?

Yes, in most cases. Income earned by dependents under age 19 (especially those who don’t file taxes) is generally not counted toward the household income for Medicaid eligibility purposes. This means your teen can have a part-time job without jeopardizing your family’s benefits.

Take control of your coverage in 2025

Whether you’re applying for the first time or renewing your coverage, staying updated on the Medicaid income limits NY 2025 is essential for accessing affordable healthcare.

If your income is near the eligibility line, there are still options—including spend-down programs and pooled income trusts—that can help you qualify. And with New York’s progressive Medicaid policies, many individuals can continue receiving coverage even if their financial situation changes slightly.

For personalized guidance or application support, visit nystateofhealth.ny.gov or speak with a licensed enrollment navigator.

Explore more

BenefitKarma is here to simplify benefits. Visit our Learn Hub for guides on Medicaid, Medicare, and financial wellness tools to help you make confident decisions about your healthcare.