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

Editorial team InsuredAndMore.com Published on October 21, 2026

📊 Texas Medicaid Income Limits for 2026

Texas Medicaid income limits depend heavily on your age, household size, and specific category, as Texas has not expanded standard adult Medicaid.

📅 Monthly Income Limits by Category

Category	Single (Monthly)	Family of 3 (Monthly)
🚸 Children (Ages 6–18)	~$1,725	Varies by tier
👶 Young Children (Ages 1–5)	~$1,870	Varies by tier
🤰 Pregnant Women	~$2,570	Varies by FPL
👨‍👩‍👧 Parents / Caretakers	~$235	~$514
🧓 Aged / Blind / Disabled (ABD)	$994	$1,450 (Couple)
🏥 Long-Term Care / HCBS	$2,982	$5,964 (Couple)
💼 Medicaid Buy-In (Working Disabled)	~$3,325	Varies

Note: For long-term care income over the $2,982 cap, applicants can utilize a Qualified Income Trust (Miller Trust) to qualify.

How much money can you make and still qualify for Medicaid in Texas?

How much money you can earn and still qualify for Texas Medicaid depends entirely on your specific eligibility group, as Texas has not adopted the Affordable Care Act (ACA) Medicaid expansion. Because of this, healthy, non-disabled adults without dependent children do not qualify for Texas Medicaid, regardless of how little money they make.

The maximum monthly gross income allowances for specific qualifying groups are structured as follows:

👥 Parents and Caretaker Relatives

Texas enforces some of the strictest limits in the nation for parents. To qualify, you must have a dependent child under age 18 living in your home, and your maximum pre-tax monthly income must fall below these extremely low flat-rate thresholds:

Household Size	Single Parent (Monthly Gross)	Two-Parent Household (Monthly Gross)
2 people	$286	$251
3 people	$343	$364
4 people	$414	$414

🤰 Pregnant Individuals

Pregnant women are eligible at much higher income tiers—up to 198% of the Federal Poverty Level (FPL). The coverage extends through pregnancy and postpartum care.

Single person (counting the unborn baby as household size of 2): ~$2,570 per month
Family of 3 (including unborn baby): ~$4,380 per month

👶 Children (Ages 0–18)

Children's Medicaid thresholds are tiered by age. If a household earns too much for regular Medicaid, they are automatically reviewed for the Children’s Health Insurance Program (CHIP), which covers kids in families making up to 201% FPL.

Children under age 1: Up to ~$2,570 per month (198% FPL)
Children ages 1–5: Up to ~$1,870 per month (144% FPL)
Children ages 6–18: Up to ~$1,725 per month (133% FPL)
CHIP (Children up to 18): Up to ~$5,528 per month for a family of 4

♿ Seniors (65+) and Adults with Disabilities

For individuals qualifying through age or permanent disability, income guidelines depend on the type of care required:

Regular Medicaid (SSI-Related / MEPD): $994 per month for a single individual, or $1,491 per month for a married couple.
Long-Term / Nursing Home Care & Home Waivers: $2,982 per month for an individual. Note: If your income is higher than this but you require long-term care, you can still qualify by setting up a Qualified Income Trust / Miller Trust to route your excess income.
Medicaid Buy-In (Working Adults with Disabilities): Up to $3,325 per month (250% FPL).

🔍 What if you don't qualify?

If your income is below 100% FPL (~$15,960/year for an individual) and you do not fit into one of the designated categories above, you will likely fall into the Texas coverage gap. However, if you make above $15,960/year (100% FPL), you can secure deeply discounted health insurance plans with premium subsidies through the federal marketplace at HealthCare.gov.

You can officially check eligibility and submit an application through the Your Texas Benefits portal.

What is the income level to qualify for Medicaid in 2026?

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.

What income is too high for Medicaid?

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.

Who is not eligible for Medicaid in Texas?

In Texas, non-disabled adults aged 19 to 64 who are not pregnant and do not care for a dependent child are not eligible for Medicaid, regardless of how low their income is.

Who Is Not Eligible

Childless, Non-Disabled Adults: Texas has not expanded Medicaid under the Affordable Care Act (ACA). Single adults and childless couples under age 65 without a qualifying disability are excluded from standard coverage.
Most Low-Income Parents: Even though children may qualify for Children's Medicaid, the income limits for parents and caretaker adults are extremely low (often around 12% of the federal poverty level). Most working parents do not qualify.
Undocumented Immigrants: Non-citizens who lack legal permanent residency or a qualified non-citizen status are generally ineligible for full Medicaid benefits, though they may qualify for emergency medical services.
Individuals Exceeding Income/Asset Caps: Those whose household income or countable assets surpass the strict limits set for their specific household size and category (such as seniors or individuals with disabilities under Medicaid for the Elderly and People with Disabilities).
Non-Texas Residents: Anyone who does not live in Texas or lacks proof of state residency.

2026 Medicaid Eligibility Limits in Texas

9 related questions found

What are the income limits for Texas Medicaid in 2026?

Texas Medicaid income limits depend on your specific household category, age, and medical needs.

💡 Standard Adult and Caretaker Limits

🛑 Parents / Caretakers
- Single monthly limit: ~$235
- Family of 3 monthly limit: ~$514
- Note: Texas has some of the strictest parent income caps in the nation.
👤 Able-Bodied Adults (Ages 19–64)
- Single gross monthly limit: ~$1,547
- Couple gross monthly limit: ~$2,082
- Note: Texas has not expanded standard adult Medicaid, making eligibility very limited for adults without children or disabilities.

🗓 Children and Pregnant Individuals

🤰 Pregnant Individuals
- Monthly income limit: ~$2,570 (198% FPL)
- Covers care throughout pregnancy and 60 days postpartum.
👶 Children (Ages 1–5)
- Monthly income limit: ~$1,870 (144% FPL)
🧒 Children (Ages 6–18)
- Monthly income limit: ~$1,725 (133% FPL)
👦 CHIP (Children's Health Insurance Program)
- Monthly income limit: ~$2,610 (201% FPL) for higher-income households.

📌 Aged, Blind, and Disabled (ABD) & Long-Term Care

♿ Aged / Blind / Disabled (Standard SSI-related)
- Individual monthly limit: $994
- Couple monthly limit: $1,491
⛰ Long-Term Care / HCBS Waivers
- Individual monthly limit: $2,982
- Couple monthly limit: $5,964
- Note: Income over $2,982 requires a Qualified Income Trust (Miller Trust) to qualify.
💼 Medicaid Buy-In (Working Disabled)
- Individual monthly limit: $3,325 (250% FPL)

How can I check my eligibility for Texas Medicaid?

You can check your eligibility and apply for benefits online at the Your Texas Benefits website.

How to Check Eligibility

Online: Log into or create an account on Your Texas Benefits to see if you qualify for programs based on your income and household size.
By Phone: Call 2-1-1 (or 877-541-7905) toll-free, Monday through Friday, from 8 a.m. to 6 p.m. Central time.
Current Recipients / Providers: If you already have Medicaid and want to verify an active status, use the TMHP Client Eligibility Lookup tool.

Information to Prepare

When you check your status or apply, have these details ready:

Names, birth dates, and Social Security numbers for household members
Pay stubs or job and income information from the last month
Details on other income like unemployment, SSI, or pensions

Does Social Security count as income for Medicaid?

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:

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).
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.

What's going to happen to Medicaid in 2026?

Stricter eligibility rules, reduced noncitizen coverage, and upcoming work requirements are taking effect for Medicaid following federal legislation passed in 2025.

Noncitizen Eligibility Changes

Effective October 1, 2026: Many lawfully present noncitizens without green cards (such as certain humanitarian immigrants, refugees, or asylum seekers) lost full federal Medicaid eligibility.
Exceptions: Green card holders, specific pregnant individuals, children, and designated statuses like Cuban/Haitian entrants remain eligible for coverage.

Upcoming 2027 Changes

Work Requirements: Starting January 1, 2027, non-exempt adults (typically ages 19–64) in the expansion group must average 80 hours per month of work, school, or community service.
More Frequent Reviews: States will require eligibility redeterminations every six months instead of annually.
Retroactive Coverage: Retroactive coverage for care received prior to enrollment will drop to 30–60 days depending on the beneficiary category.

What are common reasons for Medicaid denial?

Medicaid applications are most frequently denied because an applicant's income or countable resources exceed state financial limits.

Common Reasons for Denial

Exceeding Income or Asset Limits: Having monthly income or savings, investments, and property above your state's specific threshold.
Incomplete Documentation: Failing to provide required verification documents—such as tax returns, bank statements, or proof of identity—before the deadline.
Violating the Look-Back Period: Gifting or transferring assets for less than fair market value within 5 years (60 months) of applying, which triggers a penalty period.
Missed Agency Deadlines: Not responding to a Request for Information (RFI) or missing the timeline to submit follow-up paperwork.
Lack of Clinical or Level-of-Care Need: Failing a functional assessment for specific programs like long-term care or nursing home assistance, where applicants must show a need for help with daily activities.
Improperly Managed Trusts: Errors or improper funding involving a Qualified Income Trust (QIT) or Miller Trust when income exceeds standard limits.

You can review state-by-state guidelines and asset rules using resources like Senior Planning Services or check specific financial thresholds on Medicaid Long Term Care.