Medicaid Household Income: Everything You Need to Know

Find the household income limits for Medicaid and the Essential Plan, and learn how to figure out your Household Income

Medicaid Household Income: Everything You Need to Know

Find the household income limits for Medicaid and the Essential Plan, and learn how to figure out your Household Income

Does your family earn too much for Medicaid? Not sure if you qualify?

Find out if you meet the income requirements for Medicaid in New York.

What Is Household Income?

Medicaid household income is a portion of the money that comes into your household each year.

Whether money counts toward household income depends on where the money comes from. Here's a list of what does and does not count.

Money that counts Money that doesn’t count
Money from your job Child support you get
Money from a business you own SSI payments (this is different from Social Security)
Social Security (including disability payments) Workers' comp
Money you get when you're not working (unemployment) Money people give you as a gift
Money from rent if you own a house someone else lives in Money you get back on your taxes
Money you make from things you own (like stocks) Food stamps (SNAP)

How to Find Your Medicaid Household Income

Quick Way

Want a fast answer? Follow these steps:

  1. Add up all the money you make at work in a year - Look at your pay stubs OR multiply one month by 12
  2. Add money from other places (like Social Security)

This is an estimate of your Medicaid household income.

More Exact Way

Do you do taxes? This way uses your tax form.

  1. Find your tax form (Form 1040) from last year
  2. Look at Line 11. This number is called your Adjusted Gross Income
  3. Add any Social Security money you didn't pay taxes on
  4. Add any interest money you didn't pay taxes on

This is your Medicaid household income.

If You Make Too Much for Medicaid

You may have other ways to get help with health care costs.

Essential Plan

This plan is free or costs very little each month. It’s for adults over the age of 19. You might qualify if you make between $15,960 and $31,920 per year (for one person).

Learn more about Essential Plan.
Child Health Plus

This is for children under the age of 19. Your kids might qualify even if they do not qualify for Medicaid. Families that have higher annual income or other insurance can still qualify for this plan.

Learn more about Child Health Plus.

Questions About Income

  • Does my teenager's job count?
    It can. New York State may look at money earned by people in your home to see if you qualify. The rules can be different for each family.
  • I work for myself. What do I count?
    Count the money you keep after you pay for business things. For example, if you make $30,000 but spend $5,000 on business costs, count $25,000.
  • What if my income goes up or down?
    Let Medicaid know if your income changes. They use your current income to see if you qualify.
  • Do I need to show proof?
    Yes. You'll need things like:
    • Recent pay stubs
    • Last year’s tax form
    • A letter from your job about how much you make
    • Bank statements

Questions about Medicaid Household Income?

The MVP Customer Care Center is here to help. We can answer your questions and help you apply.

Call 1-800-TALK-MVP (825-5687) (TTY 711).

Monday–Friday, 8 am–6 pm