The following table provides eligibility levels in each state for key coverage groups that use Modified Adjusted Gross Income (MAGI), as of April 1, 2018. The data represent the principal, but not all, MAGI coverage groups in Medicaid, the Children’s Health Insurance Program (CHIP), and the Basic Health Program (BHP). All income standards are expressed as a percentage of the federal poverty level (FPL). The MAGI-based rules generally include adjusting an individual’s income by an amount equivalent to a 5% FPL disregard. Other eligibility criteria also apply, such as citizenship, immigration status, and state residency. For more information, see: https://www.medicaid.gov/medicaid/program-information/medicaid-and-chip-eligibility-levels/index.html

The Medicaid Buy-In Program for Working People with Disabilities offers people with disabilities who are working, and earning more than the allowable limits for regular Medicaid, the opportunity to keep their health care coverage through Medicaid. Eligibility requirements include certain criteria and income levels as listed here. This chart is only a guide. Individuals should see an enrollment counselor for eligibility screening. NOTE: Chart effective January 1, 2012; subject to annual income updates.

This table represents details of Medicaid income levels (ages 65 and up). Medicaid provides free health insurance for low-income older adults. Eligible adults receive their medical care through a managed care plan or fee-for-service. While ones application is being processed, Medicaid may provide up to 90 days of retroactive coverage for unpaid medical bills, if the individual is eligible during those 90 days.

This table represents details of CHP (Child Health Plus) insurance. Child Health Plus provides free or low-cost health insurance for children under the age of 19 who are not eligible for Medicaid, coverage for children. All children receive their health care through a managed care plan. There are no immigration requirements for Child Health Plus.

California State Income Limits reflect updated median income and household income levels for acutely low-, extremely low-, very low-, low- and moderate-income households for California’s 58 counties (required by Health and Safety Code Section 50093). These income limits apply to State and local affordable housing programs statutorily linked to HUD income limits and differ from income limits applicable to other specific federal, State, or local programs.

Health Care and Social Assistance Earnings in Massachusetts was 65168352.00000 Thous. of $ in October of 2024, according to the United States Federal Reserve. Historically, Health Care and Social Assistance Earnings in Massachusetts reached a record high of 65168352.00000 in October of 2024 and a record low of 16220832.00000 in January of 1998. Trading Economics provides the current actual value, an historical data chart and related indicators for Health Care and Social Assistance Earnings in Massachusetts - last updated from the United States Federal Reserve on May of 2025.

In 2022, some 20.7 percent of all uninsured children were from families with a household income below the Federal poverty level (FPL), while the uninsured rate within the same group was 6.6 percent, the second highest of all poverty levels. However, most of these children were actually eligible for Medicaid or CHIP since the median income eligibility for children was at 255% FPL. This statistic shows the percentage and rate of children uninsured in U.S. as of 2022, sorted by family poverty in terms of FPL.

The Family Planning Benefit Program (FPBP) is a free and completely confidential New York State program that provides family planning services to teens, women and men who meet certain income and residency requirements, and who are not enrolled in Medicaid or Family Health Plus. You may obtain coverage through FPBP if you meet certain Eligibility Criteria and your income is equal to or less than the income levels listed here. This chart is only a guide. Individuals should see an enrollment counselor for eligibility screening.
* Pregnant Women count as two individuals. NOTE: Chart effective January 1, 2012; subject to annual income updates.

States have the option to provide children with 12 months of continuous coverage through Medicaid and CHIP, even if the family experiences a change in income during the year. Continuous eligibility is a valuable tool that helps States ensure that children stay enrolled in the health coverage for which they are eligible and have consistent access to needed health care services.

This table represents details of Prenatal Care Services program. Prenatal Care Services through Medicaid is a comprehensive prenatal care program that offers complete pregnancy care and other health services to women and teens who live in New York State and meet income guidelines. Health insurance is available for pregnant women regardless of their immigration status. Under Prenatal Care Services, pregnant women receive prenatal health services, such as lab tests, HIV tests, nutrition screenings, and other services related to their pregnancy and for at least two months after delivery. Babies receive health care services for at least one year after birth.

This dataset includes the total number of individuals enrolled in Medi-Cal by eligibility group: Modified Adjusted Gross Income (MAGI), non-MAGI, and Children’s Health Insurance Program (CHIP). The groups are defined by the Centers for Medicare and Medicaid Services (CMS) Performance Indicators (CMSPI) reporting requirements. The Department of Health Care Services (DHCS) submits eligibility and enrollment data regarding Medicaid and CHIP monthly to CMS. The enrollment data represents enrollment totals as of 60 days after the eligibility month (indicated as “Reporting Period” in the dataset). CMS publishes the state total enrollments on the CMSPI website. The total enrollment comprises of individuals who are eligible for full scope Medi-Cal by MAGI – Child, MAGI – Adult, Non-MAGI Child, Non-MAGI Adult, and CHIP eligibility groups. DHCS does not report to CMS the total enrollment in limited scope Medi-Cal or state-only funded programs (indicated as the “Non-CMSPI” in the dataset).

Analysis of ‘Medicaid and CHIP Eligibility Levels’ provided by Analyst-2 (analyst-2.ai), based on source dataset retrieved from https://catalog.data.gov/dataset/9d477b09-ff02-43ea-ae43-8be552606d83 on 26 January 2022.

--- Dataset description provided by original source is as follows ---

The following table provides eligibility levels in each state for key coverage groups that use Modified Adjusted Gross Income (MAGI), as of April 1, 2018. The data represent the principal, but not all, MAGI coverage groups in Medicaid, the Children’s Health Insurance Program (CHIP), and the Basic Health Program (BHP). All income standards are expressed as a percentage of the federal poverty level (FPL). The MAGI-based rules generally include adjusting an individual’s income by an amount equivalent to a 5% FPL disregard. Other eligibility criteria also apply, such as citizenship, immigration status, and state residency.

For more information, see: https://www.medicaid.gov/medicaid/program-information/medicaid-and-chip-eligibility-levels/index.html

--- Original source retains full ownership of the source dataset ---

Analysis of ‘NYC Health + Hospitals Options - income eligibility - 2011’ provided by Analyst-2 (analyst-2.ai), based on source dataset retrieved from https://catalog.data.gov/dataset/4156c5bd-d223-48bb-b03b-bc107abdd4ba on 27 January 2022.

--- Dataset description provided by original source is as follows ---

The NYC Health + Hospitals Options is a discount payment scale that determines fees for NYC Health + Hospitals services for New Yorkers who do not qualify or cannot afford any of the free or low cost health insurance plans available. The reduced fees are based on family size and income. This data shows the minimum and maximum income levels needed to be eligible for the reduced rates in 2011.

--- Original source retains full ownership of the source dataset ---

Average Hourly Earnings of All Employees: Education and Health Services in Massachusetts was 32.71000 $ per Hour in January of 2021, according to the United States Federal Reserve. Historically, Average Hourly Earnings of All Employees: Education and Health Services in Massachusetts reached a record high of 32.71000 in January of 2021 and a record low of 23.73000 in January of 2007. Trading Economics provides the current actual value, an historical data chart and related indicators for Average Hourly Earnings of All Employees: Education and Health Services in Massachusetts - last updated from the United States Federal Reserve on May of 2025.

Major Eligibility Group Information for Medicaid and CHIP Beneficiaries by Year

  Description

This data set presents annual enrollment counts of Medicaid and CHIP beneficiaries by major eligibility group (children, adult expansion group, adult, aged, persons with disabilities, or COVID newly-eligible). There are three metrics presented: (1) the number of beneficiaries ever enrolled in each major eligibility group over the year (duplicated count); (2) the number of… See the full description on the dataset page: https://huggingface.co/datasets/HHS-Official/major-eligibility-group-information-for-medicaid-a.

This table represents details of Medicaid (coverage for children). Medicaid (coverage for children) is available for many children in working families. Most children who are eligible for Medicaid (coverage for children) do receive their medical care through a health plan, and visit doctors and hospitals that accept that health plan. While ones application is being processed, Medicaid (coverage for children) may provide up to 90 days of retroactive coverage for unpaid medical bills, if eligible during those 90 days

On March 5, 2014, a Notice announcing revised WIC Income Eligibility Guidelines was published in the Federal Register. The adjusted income eligibility guidelines are used by State agencies in determining the income eligibility of persons applying to participate in the WIC Program. WIC State agencies must implement the new guidelines not later than July 1, 2014. WIC State agencies may implement the revised income guidelines at the same time States implement revised income eligibility guidelines for the Medicaid Program. On January 22, 2014, the U.S. Department of Health and Human Services (HHS) published its annual update of the poverty guidelines (79 FR 3593). The HHS guidelines are used by a number of Federal programs, including WIC and the Medicaid Program, as the basis for determining and updating program income eligibility limits.

State Medicaid and CHIP Eligibility Processing Data

  Description

All states (including the District of Columbia) provide data to the Centers for Medicare & Medicaid Services (CMS) on a range of Medicaid and Children’s Health Insurance Program (CHIP) eligibility and enrollment metrics. These data reflect state-reported information on Medicaid and CHIP eligibility renewals initiated and scheduled for completion during the reporting period. In addition to reporting the… See the full description on the dataset page: https://huggingface.co/datasets/HHS-Official/state-medicaid-and-chip-eligibility-processing-dat.

Metrics from individual Marketplaces during the current reporting period. The report includes data for the states using State-based Marketplaces (SBMs) that use their own eligibility and enrollment platforms Source: State-based Marketplace (SBM) operational data submitted to CMS. Each monthly reporting period occurs during the first through last day of the reported month. SBMs report relevant Marketplace activity from April 2023 (when unwinding-related renewals were initiated in most SBMs) through the end of a state’s Medicaid unwinding renewal period and processing timeline, which will vary by SBM. Some SBMs did not receive unwinding-related applications during reporting period months in April or May 2023 due to renewal processing timelines. SBMs that are no longer reporting Marketplace activity due to the completion of a state’s Medicaid unwinding renewal period are marked as NA. Some SBMs may revise data from a prior month and thus this data may not align with that previously reported. For April, Idaho’s reporting period was from February 1, 2023 to April 30, 2023. Notes: This table represents consumers whose Medicaid/CHIP coverage was denied or terminated following renewal and 1) whose applications were processed by an SBM through an integrated Medicaid, CHIP, and Marketplace eligibility system or 2) whose applications/information was sent by a state Medicaid or CHIP agency to an SBM through an account transfer process. Consumers who submitted applications to an SBM that can be matched to a Medicaid/CHIP record are also included. See the "Data Sources and Metrics Definition Overview" at http://www.medicaid.gov for a full description of the differences between the SBM operating systems and resulting data metrics, measure definitions, and general data limitations. As of the September 2023 report, this table was updated to differentiate between SBMs with an integrated Medicaid, CHIP, and Marketplace eligibility system and those with an account transfer process to better represent the percentage of QHP selections in relation to applicable consumers received and processed by the relevant SBM. State-specific variations are: - Maine’s data and Nevada’s April and May 2023 data report all applications with Medicaid/CHIP denials or terminations, not only those part of the annual renewal process. - Connecticut, Massachusetts, and Washington also report applications with consumers determined ineligible for Medicaid/CHIP due to procedural reasons. - Minnesota and New York report on eligibility and enrollment for their Basic Health Programs (BHP). Effective April 1, 2024, New York transitioned its BHP to a program operated under a section 1332 waiver, which expands eligibility to individuals with incomes up to 250% of FPL. As of the March 2024 data, New York reports on consumers with expanded eligibility and enrollment under the section 1332 waiver program in the BHP data. - Idaho’s April data on consumers eligible for a QHP with financial assistance do not depict a direct correlation to consumers with a QHP selection. - Virginia transitioned from using the HealthCare.gov platform in Plan Year 2023 to an SBM using its own eligibility and enrollment platform in Plan Year 2024. Virginia's data are reported in the HealthCare.gov and HeathCare.gov Transitions Marketplace Medicaid Unwinding Reports through the end of 2024 and is available in SBM reports as of the April 2024 report. Virginia's SBM data report all applications with Medicaid/CHIP denials or terminations, not only those part of the annual renewal process, and as a result are not directly comparable to their data in the HealthCare.gov data reports. - Only SBMs with an automatic plan assignment process have and report automatic QHP selections. These SBMs make automatic plan assignments into a QHP for a subset of individuals and provide a notification of options regarding active selection of an alternative plan and/or, if appli

All states (including the District of Columbia) provide data to the Centers for Medicare & Medicaid Services (CMS) on a range of Medicaid and Children’s Health Insurance Program (CHIP) eligibility and enrollment metrics. These data reflect state-reported information on Medicaid and CHIP eligibility renewals initiated and scheduled for completion during the reporting period. In addition to reporting the outcomes of renewals at the end of each reporting period, states also provide an update on renewals that were reported pending as of the end of a reporting period. For more information on these data, see Sections II and III of the Eligibility Processing Data Report specifications. Notes: Georgia reported data for individuals who continue to be eligible following a change in circumstances and were granted a new 12-month eligibility period during the reporting period, along with data on individuals due for renewal in the month. North Carolina reports renewal outcomes for only initiated renewals scheduled for completion in the report month, and as such, the data do not reflect renewals that should have been completed in the reporting period that the state was unable to initiate by the end of the report month.