What are the income limits for Medicaid in Indiana in 2026?

The monthly income limits for Indiana Medicaid in 2026 vary by household size and category:

✅ Healthy Indiana Plan (HIP) — Non-Disabled Adults (Ages 19–64)

• Income Limit: Up to 138% of the Federal Poverty Level (FPL).
• Single person: $1,835.50 per month.
• Family of two: ~$2,477 per month.
• Family of four: ~$3,795.50 per month.
• Note: No asset test is required for HIP.

✅ Hoosier Healthwise — Pregnant Individuals & Children

• Pregnant Individuals: Up to 208% FPL, starting at $3,841.20 per month for a household of two.
• Children (Birth to 1 year): Up to 208% FPL.
• Children (Ages 1–18): Up to 158% FPL; higher income levels may qualify for CHIP.

✅ Aged, Blind, and Disabled (ABD) — Standard Coverage

• Single individual: $994 per month (Federal Benefit Rate baseline).
• Asset limits: $2,000 for singles; $3,000 for married couples.

✅ Long-Term Care & Home/Community-Based Waivers

• Income cap: $2,982 per month per applicant (300% of the Federal Benefit Rate).
• Excess income solution: Applicants over this limit can use a Qualified Income Trust (Miller Trust).

In 2026, single adults in states that expanded Medicaid generally qualify with an annual income below 138% of the Federal Poverty Level (FPL), which is roughly $22,025 a year (or about $1,835 per month) for a household of one.

General Income Limits by Group

• Expanded Adult Medicaid: Up to 138% FPL in states that adopted Medicaid expansion.
• Non-Expansion States: Limits vary heavily; many non-expansion states have much stricter caps for parents and non-disabled adults without children.
• Long-Term Care / Nursing Home Medicaid: In many states for 2026, the individual monthly income cap is $2,982 per month.
• Pregnant Women and Children: Often qualify at higher thresholds, frequently ranging from 150% to over 300% FPL depending on the specific state program.

Key Factors Impacting Eligibility

• State Rules: Because Medicaid is run jointly by federal and state governments, exact dollar limits change depending on where you live.
• Household Size: Income caps scale up with every additional family member in your household.
• Calculation Method: Most non-elderly adults use Modified Adjusted Gross Income (MAGI), while older adults and people with disabilities may face separate asset tests.

For most adults in states that expanded Medicaid, any household income above 138% of the Federal Poverty Level (FPL) is too high for standard adult Medicaid.

In 2026, 138% of the FPL equals about $1,481 per month (or roughly $17,773 per year) for a single individual. For a family of three, it is about $2,530 per month (or roughly $30,302 per year).

General Income Limits

• Expanded States: Adults under 65 usually qualify if income is at or below 138% FPL.
• Non-Expansion States: Limits are often much lower. Adults without children, disabilities, or pregnancy often do not qualify at all if they make over a few hundred dollars a month.
• Children and Pregnant Individuals: Income limits are much higher, often ranging from 200% to over 300% of the FPL, depending on the state.
• Long-Term Care / Seniors (65+): Gross monthly limits for nursing homes or home care are typically capped around $2,982 per month for an individual in many states, though excess income can sometimes be placed into a special trust.

What If Your Income Is Too High?

• Marketplace Insurance: If you make too much for Medicaid, you may qualify for tax credits to buy a plan on HealthCare.gov.
• Spend-Down Programs: Some states let you subtract high medical bills from your income to reach the eligibility limit.

Yes, standard Social Security benefits count as income for Medicaid eligibility. However, the exact rules depend entirely on the specific type of Social Security benefit you receive.

Types of Benefits That Count

If you receive any of the following benefits, Medicaid will include them in your monthly income calculations, even if they are not considered taxable by the IRS:

• Social Security Retirement Benefits
• Social Security Disability Insurance (SSDI)
• Social Security Survivor’s or Dependent Benefits

The Major Exception: SSI

• Supplemental Security Income (SSI) does not count as income. SSI is a separate, needs-based program for low-income individuals who are elderly, blind, or disabled. In most states, receiving SSI actually qualifies you for Medicaid automatically.

How Medicaid Evaluates Your Income

Medicaid pathways look at income in two distinct ways depending on your eligibility category:

1. MAGI Medicaid (Under Age 65 / Households): For most adults, parents, and children, eligibility is determined using Modified Adjusted Gross Income (MAGI). Under MAGI rules, your gross Social Security benefits are added directly to your household income total. (Exception: A child’s or tax dependent's Social Security check is generally excluded unless their personal income is high enough that they are legally required to file a tax return).
2. Non-MAGI Medicaid (Aged, Blind, Disabled, or Long-Term Care): If you are 65 or older, blind, or disabled, you fall into "Non-MAGI" pathways. Your standard Social Security check still counts as monthly income, but your state will also factor in an asset/resource limit (such as savings and property).

What if Your Social Security Puts You Over the Limit?

Because Medicaid is administered locally, income limits fluctuate significantly depending on your state and whether your state adopted the Affordable Care Act (ACA) Medicaid expansion. If your Social Security benefit puts you slightly over your state's threshold, you may still qualify through alternative state options like "Spend-Down" programs (Medically Needy programs) or by setting up a Qualified Income Trust (Miller Trust), depending on your local regulations.

To check the exact income limits for your household size, review the guidelines on your state's official Medicaid Agency Website.

Major changes to Medicaid in 2026 include stricter residency requirements for non-citizens enacted on October 1, as outlined by the Medicare Rights Center. Additional operational and work requirement rules are also scheduled to roll out following federal legislation.

📅 October 2026 Changes

• Stricter immigrant eligibility rules took effect on October 1.
• Lawfully present immigrants without green cards lost full benefits.
• Emergency and pregnancy-related services remain available.
• States are mailing written notices to affected individuals.

🗓 Upcoming 2027 Rules

• Work requirements begin January 1, 2027, for most adults.
• Enrollees must verify eligibility every six months.
• Retroactive coverage drops to 30 or 60 days.
• Keep contact details updated with your state agency.