2026 Medicaid Income Guidelines in New York

The Federal Poverty Level (FPL) is a federal income measure used to determine eligibility for many assistance programs. Medicaid income limits are expressed as percentages of the FPL and vary based on household size and eligibility group. For example, the 2026 adult limit shown above is 138% FPL, while the limit for pregnant individuals and children under age 1 is 223% FPL.

Income limits are based on annual federal poverty guidelines and New York Medicaid eligibility rules. Your household size and applicable eligibility category determine which limit applies. The 2026 table is based on the NY State of Health income reference; the eligibility agency makes the final determination.

Income-based Medicaid generally uses Modified Adjusted Gross Income (MAGI) rules, which consider applicable household income and tax relationships. Income may include wages, self-employment earnings, unemployment benefits, and other countable income. Not all income is treated the same way. NY State of Health can help determine what to report.

New York uses different income thresholds for different eligibility groups. In 2026, the reference sheet lists up to 138% FPL for adults, 154% for children ages 1–18, 155% for 19- and 20-year-olds living with a parent, and 223% for pregnant individuals and children under age 1. The applicable limit depends on the person seeking coverage.

There is no single Medicaid income limit for everyone. For a household of four, the 2026 annual limits shown above are $45,540 for adults, $50,820 for children ages 1–18, $51,150 for 19- and 20-year-olds living with a parent, and $73,590 for pregnant individuals and children under age 1. Other eligibility rules also apply.

Use the "Each Additional Person" row of the chart to add the appropriate annual amount for each household member beyond eight. The additional amount differs by eligibility category. NY State of Health will calculate your final household income limit.

Fidelis Care Medicaid Managed Care offers covered services without copays. You can learn more about covered benefits, including preventive services, on our website. Coverage and eligibility rules depend on the program.

Your income, age, household size, and other factors help determine whether you qualify for Medicaid, the Essential Plan, or another coverage option. NY State of Health determines eligibility based on your application. You can also explore Fidelis Care Medicaid Managed Care.

Yes. Children who qualify for Medicaid generally receive Medicaid coverage rather than Child Health Plus. The two programs have different eligibility thresholds. NY State of Health will determine the appropriate program based on your application.

Yes. Medicaid enrollment is available year-round, so you do not need to wait for a yearly open enrollment period.

Federal poverty guidelines are typically updated annually, and the corresponding Medicaid income reference may change. This page uses the 2026 figures. Check the linked NY State of Health source for official updates.

No. This chart focuses on specified income-based (MAGI) Medicaid groups. Different income and resource rules may apply to people age 65 or older, individuals with disabilities, or people applying through other Medicaid eligibility pathways. Contact the appropriate eligibility agency for guidance.

Federal changes will introduce new requirements for some Medicaid members ages 19–64, including qualifying work or other activities and more frequent renewals. Not everyone will be affected, and exemptions apply. See Important Changes Coming to Medicaid for the latest implementation details and preparation steps.

For certain affected adults, qualifying activities may include work, school, job training, or volunteering. The current Fidelis Care guidance describes an 80-hour monthly requirement or a qualifying earnings alternative and explains available exemptions. See the 2027 Medicaid changes page for the complete criteria and effective dates.

Some affected Medicaid members will be required to verify eligibility every six months instead of annually beginning in 2027. Your official renewal notice will explain whether this applies to you and what information to provide. Read the Medicaid coverage changes for details.

Keep your contact information current with NY State of Health, read any notices about your coverage, and follow the instructions provided for your renewal. Visit NY State of Health Stay Covered and our Medicaid changes page. If you enrolled through your county Department of Social Services, contact that office to update your information.

A Social Care Network connects eligible members with local organizations offering support related to housing, nutrition, transportation, and care management. You may qualify for free support services. Visit the Social Care Network page to learn more.

Visit Medicaid Managed Care Member Resources for plan documents, benefits information, and tools to help manage your coverage.