Is Income-Based Medicaid Right for You?

Medicaid is government-funded health coverage for people in certain situations. You may qualify if you:

Answer the questions on this page to see if you might qualify for income-based Medicaid. If so, it’s probably your best health coverage option because it doesn’t usually have a premium, the copayments for services are generally lower than copayments required by private plans, and Medicaid covers more services than most private plans. Also, if you qualify for Medicaid, you cannot get government help paying for an individual plan on Healthcare.gov.

Do You Meet Income-Based Medicaid’s Basic Requirements?

To qualify for income-based Medicaid, you must:

  • Be under 65 years old
    • You can be 65 or older if you are the parent or caretaker of a child.
  • Not qualify for Medicare
    • You can be on Medicare if you are the parent or caretaker of a child or are pregnant.
  • Be a U.S. citizen or meet specific noncitizen requirements

If you are under 65, do not qualify for Medicare, and are either a U.S. citizen or a noncitizen who qualifies, income-based Medicaid might cover you.

Medicaid’s rules for immigrants:

  • Undocumented immigrants do not qualify for full Medicaid coverage, but they may qualify for Medicaid coverage for emergency services.
  • Most immigrants who have been lawfully present for less than five years do not qualify for full Medicaid coverage. However, if their income is at or below 400% of the Federal Poverty Guidelines (FPG), they can get private coverage subsidized by the government.
  • Immigrants who have been lawfully present for five years or longer and some other noncitizens who meet specific noncitizen requirements qualify for the same programs that U.S. citizens can get.

Is Your Income Low Enough for Income-Based Medicaid?

These are the main income rules for income-based Medicaid:

  • If your family’s income is at or under 138% of the Federal Poverty Guidelines (FPG) ($16,753 per year for an individual; $34,638 for a family of four), you may qualify.
  • If you are 18 or younger and your family’s income is at or under 217% of FPG ($54,467 per year for a family of four), you may qualify.
  • If you are pregnant and your family’s income is at or under 200% of FPG ($50,200 per year for a family of four), you may qualify. The unborn baby is counted as a family member.

Income-based Medicaid is based on your Modified Adjusted Gross Income (MAGI), which includes most earned and unearned income. (That's why some people call it "MAGI Medicaid.") However, some income is not counted, including Supplemental Security Income (SSI) benefits and some contributions to retirement accounts. Learn more about what types of income affect income-based Medicaid eligibility.

If you are 21 or older and your household's income is between 100% of FPG and 138% of FPG, you may have to pay a small premium for income-based Medicaid (usually $26 per month or less). The Healthy Michigan Plan website has more information about premium (contribution) amounts.

Note: There are no limits to how much money or other resources you can have for income-based Medicaid.

Health Coverage Income Limits for Your Family

If your income is low enough and you meet all other requirements, you should sign up for Medicaid.

Is income-based Medicaid’s income limit 133% or 138% of FPG?

You may see the income limit for income-based Medicaid listed as 133% of FPG in some places. However, when Medicaid counts your income, they’ll knock 5% of FPG off your income if you make more than 133% of FPG. That's why we say that you can make up to 138% of FPG, because it more accurately shows how much income you could have and still get Medicaid. For children, this means we show 217% of FPG as the limit, instead of 212%.

More Ways to Qualify for Medicaid if You Have a Disability

There are other ways to qualify for Medicaid if you have a disability. You might qualify for SSI-related Medicaid if:

  • You get Supplemental Security Income (SSI) benefits.
  • You make more money at work than income-based Medicaid allows. In that case, you could apply for Freedom to Work.
  • You also get Medicare. Usually, Medicaid doesn’t cover people getting Medicare, but SSI-related Medicaid does. It may even help pay your monthly Medicare premiums.
  • You are 65 years old or older.

You might qualify for income-based Medicaid, even though you have a disability, if:

  • Your disability does not meet Social Security’s definition of disability. SSI-related Medicaid is only for people who have disabilities meeting this standard.
  • You have more resources than are allowed by SSI-related Medicaid.
  • You make enough money that you would have to pay a monthly premium for Freedom to Work.

Learn more about SSI-related Medicaid and Freedom to Work.

How to Sign Up

You can apply for Medicaid:

Note: With MIBridges, you can apply for the Food Assistance Program (formerly Food Stamps), the Family Independence Program (FIP), and other benefits at the same time as you apply for Medicaid.

For help with your application, visit or call your local county human services agency or call the Medicaid Beneficiary Help Line at 1-800-642-3195 or 1-866-501-5656 (TTY).

Staying on Medicaid

Usually, once approved for Medicaid, you continue to qualify as long as your situation doesn’t change. If your income, immigration status, residency, or household size changes, let your county human services agency know within 10 days of the change. You can do this in person, by phone, or by email. When you report your changes, the county tells you whether you continue to get Medicaid or if you have new health coverage options, like individual coverage with subsidies or Freedom to Work.