New York Medicaid Income Limits 2026: Chart and EP

Applying costs nothing, and Medicaid is health coverage rather than a cash payment. For other states and the national picture, see our national Medicaid income limits guide.

New York Medicaid Income Limits by Household Size (2026)

New York uses 6 MAGI income bands for Medicaid, from 100% to 223% of poverty, and the band that applies depends on age and pregnancy. According to the New York State Department of Health 2026 Medicaid income data, a household of four can have up to $3,795 a month as adults or parents, $4,235 for a child 1 to 18, and $6,133 for a pregnant person or baby. All amounts are gross monthly income.

Sources: New York State Department of Health, Income Standards for MAGI Population, effective January 1, 2026 (opens in a new tab) (attachment to GIS 26 MA/05); the Essential Plan column is the 200% column of the non-MAGI page of the same chart. Free Child Health Plus figures come from the Child Health Plus table (opens in a new tab) for applications received on or after February 17, 2026. New York's chart prints 138%, 154% and 223% as the working limits; the federal 5% disregard is already built into those numbers.

Yearly limits and Child Health Plus premium bands

Sources: Department of Health 2026 MAGI and non-MAGI charts (yearly columns) and the Child Health Plus table. Child Health Plus premiums are $15, $30, $45 or $60 per child per month, capped at three children per family, and families above the $60 band pay the health plan's full premium. There are no copays in Child Health Plus.

Seniors, disability and long-term care limits

New York measures people who are 65 or older, blind or disabled against a separate "Medicaid Income Level," and it's far more generous on resources than most states.

Sources: Department of Health Income and Resource Standards for Non-MAGI Population, effective January 1, 2026 (opens in a new tab) and GIS 26 MA/03 (opens in a new tab). The SSI federal benefit rate New York lists for 2026 is $994 for one person and $1,491 for a couple, with a state supplement of $87 and $104 for people living alone.

How New York Counts Your Income

New York runs 2 separate budgeting systems, and which one you're in decides both your limit and whether your savings matter.

MAGI budgeting covers children, parents and caretakers, pregnant people, 19 and 20 year olds and adults 19 to 64 without Medicare. It follows federal tax rules: wages, net self-employment income, unemployment benefits and taxable Social Security count, while child support received and SSI payments don't. Your household is usually your tax household, and a pregnant person counts each expected child. The Department of Health chart marks every MAGI group "No Resource Test," so savings and a car don't affect eligibility.

The 5% disregard is already folded into New York's printed limits. The adult group is technically 133% of poverty, and the state publishes it as 138% ($1,836 for one person) so you don't have to do the math. The children's 154% and pregnancy 223% figures work the same way.

Non-MAGI budgeting applies to people who are 65 or older, blind, disabled, or on Medicare, and to nursing home and home care cases. It uses SSI-style rules with deductions and a resource test. When countable income is above $1,836 for one person, New York doesn't simply deny; it sets a monthly spenddown equal to the excess, which you meet with medical bills, much like an insurance deductible.

For example, a family of three in Buffalo earning $3,400 a month gross (a parent, a 4-year-old and a 10-year-old) splits across programs. The parent is specifically $258 over the $3,142 Medicaid line for three, so the parent doesn't get Medicaid but falls well under the Essential Plan's $4,554 limit. Both children qualify for Medicaid, because New York uses one 154% limit ($3,507 for three) for every child from 1 to 18. The whole family can apply on one NY State of Health application.

New York Medicaid Asset Limits

$33,038 is the 2026 resource limit for one person in the SSI-related group, and $44,796 applies to a couple, according to the state Medicaid resource data in the January 1, 2026 chart. That's more than 16 times the $2,000 SSI limit used in many states. Adults, parents, children and pregnant people on MAGI Medicaid have no resource test at all.

Long-term care adds three more rules worth knowing:

• Nursing home residents keep a $50 monthly personal needs allowance, and most other income goes to the facility. The resource limit stays at $33,038.
• Spousal protection: the spouse at home keeps resources equal to the greater of $74,820 or half the couple's assets, up to $162,660, plus income up to $4,066.50 a month, according to GIS 26 MA/03.
• Home equity: a home with more than $1,130,000 in equity blocks Medicaid payment for nursing facility and community-based long-term care,, according to GIS 26 MA/03.

Medicare Savings Programs (QMB and QI) have no resource test in New York, so an older adult with savings above $33,038 can still get help with Medicare premiums. Transfers of money or property for less than fair market value before applying for nursing home care can trigger a penalty period, so a family planning ahead should talk with a legal services office or an elder law attorney.

Expansion vs Non-Expansion: New York's Position in 2026

New York expanded Medicaid, so 138% of poverty covers adults 19 to 64 whether or not they have children, and parents use the same 138% line. The Medicaid.gov eligibility levels table (opens in a new tab) (as of December 1, 2023) lists New York at 133% for parents, 149% for children 1 to 18, 218% for pregnancy, 400% for separate CHIP and 200% for adults through the Basic Health Program; the state chart's figures are higher by the 5% disregard. New York runs a Basic Health Program, the Essential Plan, which fills the gap just above Medicaid for adults. In non-expansion states, single adults often get nothing; our Texas Medicaid income limits guide shows that gap, and our Pennsylvania guide covers a neighboring expansion state.

What already changed in 2026.

• Essential Plan back to 200%, July 1, 2026. According to the Department of Health's March 23, 2026 announcement, CMS approved New York's request to end its Section 1332 waiver after federal law removed about half the program's funding. Roughly 1.3 million enrollees under 200% of poverty kept the Essential Plan; about 450,000 between 200% and 250% lost it and were pointed to Qualified Health Plans, where most pay premiums for the first time.
• Immigrant coverage, October 1, 2026. NY State of Health says refugees, asylees, parolees and survivors of domestic violence or trafficking may move from Medicaid to the Essential Plan, with no change in benefits. Coverage for children, pregnant people and people who recently gave birth didn't change. Affected members were notified September 1 to 4, 2026.

What starts January 1, 2027. NY State of Health lists these federal changes:

• Work requirements for some adults 19 to 64: income of at least $580 a month, or 80 hours a month of work, school at least half time, job training or volunteering, or a mix. NY State of Health's own example: $380 in monthly earnings counts as 52 hours at the $7.25 federal minimum wage, leaving 28 hours to make up.
• 6-month renewals for some adults 19 to 64, instead of once a year. The NYC Health Department says current members may face the new rules starting with March 2027 renewals.
• Shorter retroactive coverage for past medical bills.

Exemptions include people 18 or younger or 65 or older, people who are pregnant or were in the last 12 months, Medicaid enrollees with a disability, people on Medicare, American Indians and Alaska Natives, parents or caretakers of a child under 14 or of a disabled person, people in drug or alcohol treatment, people meeting SNAP or cash assistance work rules, former foster youth under 26, people released from jail or prison in the last 3 months, and veterans with a total disability. Notices about work requirements went out between August 14 and September 30, 2026.

What the New York Department of Health Doesn't Tell You About These Limits

Grantsights compared the state's charts, notices and program pages and found 5 points that the headline numbers leave out:

1. The Essential Plan cut is bigger than it looks. Grantsights analysis of the 2026 Department of Health chart shows the drop from 250% to 200% lowered the Essential Plan ceiling by $665 a month for one person ($3,325 to $2,660) and $1,375 a month for four ($6,875 to $5,500). Someone earning $35,000 a year alone was eligible in June and isn't now.
2. Two charts carry "2026" in the title. GIS 26 MA/03 (January 23) still printed the 2025 poverty levels, with $1,800 as the one-person adult limit. The February 13 chart in GIS 26 MA/05 replaced it with $1,836, retroactive to January 1. If a worker or website quotes $1,800 or $3,698 for four, it's using the old chart.
3. Child Health Plus has no income ceiling. According to the Child Health Plus program table, free coverage for a family of four runs to $6,105 a month, $1,870 above the $4,235 Medicaid limit for a school-age child, and families over the $11,000 top band can still buy in at the plan's full premium. Many parents underestimate how far up that scale their kids are covered.
4. Senior savings rules are unusually generous. The $33,038 resource limit for one person is far above most states, and Medicare Savings Programs check no resources at all. An older adult who assumes their savings disqualify them is often wrong.
5. Over-income doesn't mean ineligible for older adults. Under the non-MAGI spenddown, a senior whose countable income after deductions is $2,300 a month has a $464 monthly excess over the $1,836 line, and Medicaid pays once medical bills cover that amount, instead of turning the person away.

Common Mistakes and Red Flags

These are the errors that most often lead to a wrong answer on New York eligibility:

• Using net pay. Every New York Medicaid limit is gross monthly income. Pre-tax health and retirement contributions come off; taxes don't.
• Quoting the January chart. A common mistake is using the $1,800 one-person figure from GIS 26 MA/03 rather than the $1,836 that took effect retroactively.
• Assuming the Essential Plan still goes to 250%. Since July 1, 2026, the line is 200%. People between 200% and 250% need a Qualified Health Plan with tax credits.
• Skipping the children after a parent is turned down. Each person is checked separately, and Child Health Plus covers kids at any income.
• Paying for help to apply. Medicaid, the Essential Plan and Child Health Plus applications are free, and so are certified enrollment assistors. A red flag is anyone who asks for a fee, gift cards or your bank login to file for you or to "guarantee" approval.
• Ignoring renewal mail. From 2027, some adults renew every 6 months. NY State of Health asks members to keep their address, phone and email current so notices don't go missing.

How to Apply for New York Medicaid and How Long It Takes

Federal rules give New York up to 45 days to decide most Medicaid applications and 90 days when eligibility depends on a disability, under 42 CFR 435.912 (opens in a new tab).

1. Online: through NY State of Health (opens in a new tab), the marketplace that handles Medicaid for children, parents, pregnant people and adults under 65, plus the Essential Plan, Child Health Plus and Qualified Health Plans.
2. By phone: the NY State of Health Customer Service Center at 1-855-355-5777 (TTY 1-800-662-1220).
3. In person: with a free certified enrollment assistor, or at your county's Local Department of Social Services (the Human Resources Administration in New York City). People 65 and older, people on Medicare, and nursing home or home care applicants usually apply through the local department rather than the marketplace.

Have pay stubs or a tax return, Social Security numbers, and proof of identity and immigration status ready. Senior, disability and long-term care applications also need bank statements and insurance and property records. If you also need food help, our New York food stamps guide explains SNAP, which uses different limits.

What to Do If You're Denied

You have 60 days from the date on the notice to request an appeal, according to NY State of Health's appeals questions page (opens in a new tab). If you're on Medicaid and the notice ends or reduces it, ask within 10 days of the notice date, or before the effective date on the notice if that's later, and your coverage continues until the decision. You can appeal by phone at 1-855-355-5777, by fax at 1-855-900-5557, or by mail. The same page sends appeals about a Medicaid health plan's coverage decisions to the state's Office of Administrative Hearings at 1-800-342-3334.

Read the reason on the notice first. If it's income, check that the worker used gross monthly income, the right household size and the 2026 chart. NY State of Health warns that if the appeal goes against you, you may be responsible for the cost of coverage used while it was pending, so weigh that before asking for continued benefits.

If You're Over the New York Medicaid Limit

Being just over $1,836 still leaves at least 5 routes, and for most working adults the Essential Plan is the first one to check:

• Essential Plan: adults 19 to 64 up to 200% of poverty, $2,660 a month for one person in 2026.
• Qualified Health Plans with tax credits through NY State of Health above 200%; see HealthCare.gov's savings page (opens in a new tab) for how premium tax credits work. Losing Medicaid or the Essential Plan opens a special enrollment period.
• Child Health Plus for anyone under 19, free up to about 222% of poverty and with premiums of $15 to $60 per child up to about 400%.
• Medicare Savings Programs if you have Medicare: QMB to $1,836 and QI to $2,474 a month for one person, with no resource test.
• Spenddown for people 65 or older, blind or disabled whose income is over the Medicaid Income Level.

Our federal poverty guidelines guide shows every percentage band, our WIC income limits guide covers pregnant women and young children, and our SSI income limits guide and help for seniors programs guide cover older adults. For heating bills, see our LIHEAP income limits guide. Neighbors can compare New Jersey Medicaid income limits and Connecticut HUSKY Health income limits. If you need help beyond health coverage, Grantsights' free eligibility checker points you to official programs for rent, utilities and other needs; it doesn't decide Medicaid eligibility or submit anything for you.

FAQ: New York Medicaid Income Limits

What is the income limit for Medicaid in New York in 2026?

Adults and parents: $1,836 a month alone, $3,795 in a household of four (2026 chart).

What is the Essential Plan income limit in 2026?

200% of poverty since July 1, 2026: $2,660 a month for one person.

How much can a family of 4 make and get Child Health Plus in New York?

Free up to $6,105 a month; premium bands up to $11,000; full-premium buy-in above that.

What is the New York Medicaid income limit for pregnant women?

$4,022 a month for a household of two and $5,077 for three.

What are the New York Medicaid limits for seniors and people with disabilities?

$1,836 a month and $33,038 in resources for one person, with a spenddown above that.

Does New York have an income cap for nursing home Medicaid?

No cap; residents keep $50 a month and the resource limit is $33,038.

When do Medicaid work requirements start in New York?

January 1, 2027, for some adults 19 to 64, checked at renewals from March 2027.

How long do I have to appeal a Medicaid decision in New York?

60 days from the notice date; 10 days to keep Medicaid during the appeal.

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Sources

1. New York State Department of Health: Income and Resource Standards, effective January 1, 2026 (opens in a new tab), attachment to GIS 26 MA/05, revised February 5, 2026
2. New York State Department of Health: GIS 26 MA/05, 2026 Federal Poverty Levels (opens in a new tab), February 13, 2026 - effective January 1, 2026; loaded February 17, 2026
3. New York State Department of Health: GIS 26 MA/03, 2026 Medicaid Levels and Other Updates (opens in a new tab), January 23, 2026 - SSI rate, spousal amounts, home equity limit
4. New York State Department of Health: GIS 26 MA/03 chart (2025 poverty levels) (opens in a new tab)
5. New York State Department of Health: Child Health Plus Eligibility and Cost (opens in a new tab), revised February 2026
6. New York State Department of Health: Federal approval to preserve health coverage (opens in a new tab), March 23, 2026 - Essential Plan change July 1, 2026
7. NY State of Health: Changes to Medicaid Coverage (opens in a new tab), published November 2, 2026
8. NY State of Health: Questions about Appeals (opens in a new tab)
9. NYC Health Department: Medicaid Coverage Changes (opens in a new tab)
10. eCFR: 42 CFR 435.912, Timely determination of eligibility (opens in a new tab)
11. HHS ASPE: 2026 Poverty Guidelines (opens in a new tab)
12. Medicaid.gov eligibility levels table (December 2023 data), used here for New York (opens in a new tab), as of December 1, 2023
13. HealthCare.gov: Lower costs on Marketplace coverage (opens in a new tab)