New Mexico Medicaid—known as Centennial Care—provides low- or no-cost health coverage for more than 900,000 residents, covering doctor visits, hospital care, and prescriptions.
In 2025, income eligibility updates with the latest Federal Poverty Level (FPL) changes to reflect inflation and rising living costs.
These updates affect children, pregnant women, adults, seniors, and people with disabilities. For a full comparison of qualifying income levels nationwide, visit our Medicaid income limits by state page.
This guide is built for parents exploring children’s coverage, expecting moms needing prenatal care, working adults reviewing expansion rules, and seniors living on fixed incomes.
You’ll find simple explanations of FPL basics, income limits by group, household size rules, MAGI vs. non-MAGI categories, countable income, SSI-related assets, monthly vs. annual income calculations, required documents, and easy charts with the updated numbers.
Key Definitions & Program Types
MAGI (Modified Adjusted Gross Income) covers kids, pregnant women, parents, and expanded adults; it’s tax-based with no asset test. Non-MAGI handles elderly (65+), blind, disabled, long-term care, and Medicare Savings, it checks monthly income plus assets.
Family size counts you, spouse, kids under 19, +1 for pregnancy; tax household for MAGI, shared costs for non-MAGI. FPL is the federal base, starting $1,305 monthly ($15,660 yearly) for one in 2025, +$459 ($5,508) per extra percentages set limits.
Quick Reference: MAGI vs Non-MAGI Categories
| Type | Groups | Key Feature |
| MAGI | Children, pregnant, parents, adults 19–64 | No assets, tax AGI-based |
| Non-MAGI | Elderly, disabled, LTC, Medicare Savings | Income + assets, monthly focus |
Children’s Medicaid (0–18 / 0–19)
New Mexico covers children 0-18 up to 200% FPL for under 6 and 138% for 6-18, through Medicaid and CHIP for preventive care like checkups, shots, and dental. It’s family-focused with EPSDT for full needs, no asset test.
Children Under 6 (200% FPL)
| Family Size | Monthly Income Limit | Annual Income Limit |
| 1 | $2,610 | $31,320 |
| 2 | $3,530 | $42,360 |
| 3 | $4,450 | $53,400 |
| 4 | $5,370 | $64,440 |
Children 6–18 (138% FPL)
| Family Size | Monthly Income Limit | Annual Income Limit |
| 1 | $1,799 | $21,588 |
| 2 | $2,432 | $29,184 |
| 3 | $3,065 | $36,780 |
| 4 | $3,698 | $44,376 |
2025 teledentistry aids rural access; CHIP picks up at 200-300% FPL with premiums.
Pregnant Women
Pregnant women qualify up to 250% FPL, counting the baby as +1, with coverage for prenatal care, labor, delivery, and 12 months postpartum for checkups and planning. It’s medically needy if over, with a spend-down option.
Pregnant Women (250% FPL)
| Family Size | Monthly Income Limit | Annual Income Limit |
| 2 (Mom + Baby) | $3,263 | $39,156 |
| 3 | $4,411 | $52,932 |
| 4 | $5,559 | $66,708 |
Medicaid vs CHIP Perinatal: Medicaid full for mom up to 250%; CHIP fetal only up to 200% if ineligible.
Adult Expansion (19–64)
New Mexico’s expansion covers adults 19-64 up to 138% FPL, no kids required for doctor visits, meds, and mental health. Verification uses MAGI, no assets.
Adult Expansion (138% FPL)
| Family Size | Monthly Income Limit | Annual Income Limit |
| 1 | $1,799 | $21,588 |
| 2 | $2,432 | $29,184 |
| 3 | $3,065 | $36,780 |
| 4 | $3,698 | $44,376 |
Low-income adults get full benefits; disabilities bump to non-MAGI with extras.
Parents & Caretakers
Parents or caretakers qualify up to 41% FPL if caring for a child under 19, linking to family support with low thresholds and retroactive coverage up to 3 months.
Parents / Caretakers (41% FPL)
| Family Size | Monthly Income Limit | Annual Income Limit |
| 1 | $535 | $6,420 |
| 2 | $723 | $8,676 |
| 3 | $911 | $10,932 |
| 4 | $1,099 | $13,188 |
Caretakers get family planning and checkups; renewals yearly.
Aged, Blind & Disabled (Non-MAGI)
ABD Medicaid uses non-MAGI with SSI limits: $967 monthly for individuals ($1,450 couples), automatic for SSI recipients, with asset test. Deductions for work/medical expenses help.
Aged, Blind & Disabled (SSI-Based)
| Group | Monthly Income Limit | Annual Income Limit |
| Individual | $967 | $11,604 |
| Couple | $1,450 | $17,400 |
LTC transitions to waivers; spousal protection allows $3,000/month for non-applicant.
Long-Term Care / Institutional Care
Long-term care qualifies up to 300% SSI ($2,901 monthly individual) with $2,000 asset limit ($3,000 couple). Spend-down uses excess on bills; spousal impoverishment protects $157,920 assets for non-applicant.
Long-Term Care (300% SSI)
| Group | Monthly Income Limit | Annual Income Limit |
| Individual | $2,901 | $34,812 |
| Couple | $4,351 | $52,212 |
Eligibility verification needs medical proof; allowable expenses deduct from income.
Medicare Savings Programs (QMB, SLMB, QI-1)
QMB up to 100% FPL ($1,305 monthly individual) pays Medicare Part A/B premiums; SLMB 120% ($1,566); QI-1 135% ($1,761). Assets $2,000/$3,000 for QMB.
QMB (100% FPL)
| Family Size | Monthly Income Limit | Annual Income Limit |
| 1 | $1,305 | $15,660 |
| 2 | $1,763 | $21,156 |
| 3 | $2,221 | $26,652 |
| 4 | $2,680 | $32,160 |
SLMB (120% FPL)
| Family Size | Monthly Income Limit | Annual Income Limit |
| 1 | $1,566 | $18,792 |
| 2 | $2,116 | $25,392 |
| 3 | $2,666 | $31,992 |
| 4 | $3,216 | $38,592 |
QI-1 (135% FPL)
| Family Size | Monthly Income Limit | Annual Income Limit |
| 1 | $1,761 | $21,132 |
| 2 | $2,380 | $28,560 |
| 3 | $2,999 | $35,988 |
| 4 | $3,617 | $43,404 |
Benefits include deductibles; retroactive up to 3 months.
Assets & Special Rules
Non-MAGI groups like elderly/disabled have asset limits: $2,000 individual, $3,000 couple. Exempt: Home, one car ($4,500 value), household goods, burial funds ($1,500). MAGI skips assets. Ohio Medicaid asset limits protect essentials, spousal rules allow $157,920 for non-applicant in LTC.
How to Apply & Verify Eligibility
Step-by-step:
1. Online : Benefits.ohio.gov screen, upload docs, 45 days.
2. Phone : 800-324-8680, bilingual.
3. In-Person : County Job & Family Services.
4. Mail : Form from medicaid.ohio.gov to local office.
5. Newborn : Auto 12 months, report birth. Shutdown backlog adds 1-2 weeks; presumptive for pregnancy is 5 days.
Required Documents
Income: Pay stubs (4 weeks), tax returns, W-2s.
ID: License, birth certificate.
Residency: Bill.
Pregnancy: Note.
Disability: SSA letter.
Self-employed: Profit/loss.
Common Reasons People Get Denied
Over income from unreported extras. Wrong or missing docs. Household miscount (forget spouse). Duplicate benefits without adjustment. Citizenship issues, emergency for undocumented.
FAQ Section
What is the income limit for a single adult in Ohio in 2025?
Single adults 19-64 qualify up to 138% FPL ($1,732 monthly, $20,784 yearly). No kids needed, expansion covers essentials.
Can working adults qualify for Medicaid in Ohio?
Yes, up to 138% FPL after 5% disregard, MAGI counts earnings. Waivers for disabled workers go to 250% FPL.
Do I need to be a U.S. citizen?
Yes, for full Medicaid, qualified immigrants wait 5 years. Undocumented emergencies for crises like birth.
What if my income changes month to month?
Average last three months for MAGI; project annual for non-MAGI. Report changes in 10 days to adjust.
How long does approval take?
Up to 45 days; presumptive for pregnancy is 5 days. Shutdown backlog adds 1-2 weeks, track online.
Does Ohio have emergency Medicaid?
Yes, for life-threats like accidents or labor, even undocumented. Covers treatment, not follow-up.
Final Summary
Ohio Medicaid income limits 2025 keep coverage open, FPL charts show paths for all, from kids at 206% to seniors on SSI. Assets matter only for non-MAGI, and changes like pregnancy raise limits. Apply soon, ODM guides you. The 5% disregard helps borderline cases; check waivers for extras. Your health’s priority, get started today.
