New York Medicaid Income Limits 2026: Complete Eligibility Guide

Last Updated: January 9, 2026 — New York State is currently using 2025 Federal Poverty Level (FPL) figures for all Medicaid applications.

The official 2026 income limits will be released by the federal government in late January or February, with New York typically adopting the new limits in March or April 2026, retroactive to January 1st.

New York Medicaid is one of the most comprehensive programs in the country, offering health coverage to millions of residents.

In 2026, eligibility continues to be determined by income thresholds based on FPL, with expanded access for adults, children, pregnant women, and seniors.

Unlike states with stricter rules, New York has embraced expansion and continues to lead in providing affordable care.

Key Takeaways

• Adults 19–64 qualify up to 138% FPL (currently $1,800/month, will increase in March 2026)
• Pregnant women and children are covered at higher thresholds, often above 200% FPL
• Seniors and disabled residents qualify under income and asset-based rules
• Major asset limit increase to $300,000 is pending federal approval
• Applications are processed through the NY State of Health marketplace

🆕 What’s New in 2026

Current Status (January 2026):

• 2025 income limits remain in effect until new FPL guidelines are released
• Single adult limit: $1,800/month (138% FPL)
• Couple limit: $2,433/month (138% FPL)
• Essential Plan: $3,260/month (250% FPL)

Coming Changes:

• New 2026 FPL expected to be published mid-to-late January 2026
• New York will adopt updated limits in March or April 2026, retroactive to January 1st
• Income limits expected to increase by approximately 2-3%
• Pending: Asset limit may increase from ~$32,000 to $300,000 (Bill A01043, awaiting federal approval)

New York Medicaid in Context

New York has consistently maintained one of the largest Medicaid programs in the nation, covering more than 7 million residents as of 2024.

Its broad eligibility rules, combined with expansion under the Affordable Care Act, make it easier for low-income adults to gain coverage compared to states like Texas or Florida.

If you’re curious about how New York’s generous limits compare to other states, check our comprehensive guide on Medicaid income limits across all 50 states in 2026.

The state also invests heavily in children and maternal health. Pregnant women are covered up to 223% FPL, one of the highest thresholds in the country.

Children are supported through Medicaid and Child Health Plus, ensuring nearly universal pediatric coverage.

Seniors and people with disabilities qualify through the Aged, Blind, and Disabled Medicaid program. These applicants face income and asset tests, but New York offers unique long-term care waivers, allowing individuals to receive care at home instead of entering nursing facilities. This makes the program especially supportive for families managing elderly care.

💰 Income Limits by Category (2026)

Adults Ages 19–64 (MAGI Medicaid)

Current limits valid until March 2026

Covered under Medicaid expansion up to 138% of FPL, ensuring broader access compared to non-expansion states.

Pregnant Women & Infants

Current limits valid until March 2026

Pregnant women qualify up to 223% FPL, among the highest limits nationwide, with extended postpartum coverage for 12 months.

Children (Ages 1–19)

Children qualify at higher income levels through Medicaid or Child Health Plus. Yes, children can qualify even if parents don’t, as children’s eligibility is calculated at higher income thresholds.

Seniors (65+) and People with Disabilities (Non-MAGI)

Current limits for 2026

Important: Seniors and disabled applicants ages 65+ are now tied to the 138% FPL level ($1,800/month) rather than the old SSI-based limits. Asset tests still apply, but a significant legislative change (Bill A01043) could raise the asset limit to $300,000 pending federal approval.

Essential Plan (Unique to New York)

Current limits valid until April 2026

The Essential Plan is a low-cost coverage option for adults earning between 138% and 250% FPL, unique to New York State.

📊 Income Limits Comparison Table (2025 vs 2026)

Timing Note: These limits are based on the 2025 Federal Poverty Level ($15,060/year for one person). When the 2026 FPL is published (expected mid-to-late January 2026), these dollar amounts will increase.

New York State typically issues a “General Information System” (GIS) message in March to formally adopt the new numbers, retroactive to January 1st.

Who Qualifies for New York Medicaid?

Understanding who qualifies can be complex, so we’ve broken it down by category. For more detailed information about the complete application process and qualifying factors, see our full guide on Medicaid eligibility requirements for 2026.

Adults 19–64

Covered under expansion up to 138% of FPL (currently $1,800/month), ensuring broader access compared to non-expansion states. No asset test for MAGI adults.

Children

Children qualify at higher income levels, often up to 154% FPL through Medicaid and up to 400% FPL through Child Health Plus.

Pregnant Women

Pregnant women qualify up to 223% FPL (currently $2,909/month), with extended postpartum coverage for 12 months.

Seniors and People with Disabilities

The Aged, Blind, and Disabled program applies strict income and asset tests. However, New York offers long-term care waivers that allow services at home rather than only in nursing facilities. Asset limits may significantly increase in 2026 pending federal approval.

Asset & Resource Limits Explained

For “Non-MAGI” applicants (Age 65+, Blind, or Disabled), Medicaid considers your accumulated assets including savings, stocks, and second properties.

MAGI applicants (children, adults under 65) have NO asset test.

This potential change would dramatically expand access for middle-class seniors and disabled individuals who have modest savings but still need Medicaid coverage.

How to Apply for Medicaid in New York (2026)

Before applying, you can quickly estimate your eligibility using our Medicaid income calculator for 2026 to see if you qualify based on current income limits.

Application Steps:

1. Start at the NY State of Health marketplace
2. Use the eligibility tool to estimate your coverage options
3. Gather required documents:
   • Proof of income (pay stubs or tax forms)
   • Proof of residency (lease, bill, ID)
   • Social Security numbers for household members
   • Immigration documents, if applicable
4. Submit your application online, by mail, or with an enrollment assister
5. Renew coverage annually by updating household and income information

Alternatives if You Don’t Qualify

If your income is slightly above Medicaid limits, other programs are available:

Child Health Plus: Affordable coverage for children whose family income exceeds Medicaid limits, up to 400% FPL.

Essential Plan: For adults up to 250% FPL (currently $3,260/month for individuals), offering lower-cost coverage with state funding support. This program is unique to New York.

Marketplace Plans: Subsidies on HealthCare.gov help higher-income residents buy insurance.

Community Health Centers: Provide low-cost care for uninsured adults across New York.

FAQs

Conclusion

New York Medicaid in 2026 continues to stand out as one of the broadest systems in the country. Adults are covered up to 138% FPL (currently $1,800/month), while pregnant women and children benefit from higher thresholds up to 223% and 400% FPL respectively. Seniors and disabled individuals receive additional support through long-term care waivers, and may soon benefit from dramatically increased asset limits.

If you think you qualify, start your application through the NY State of Health marketplace. For those above Medicaid limits, programs like Child Health Plus and the Essential Plan provide affordable alternatives.

Stay Updated: Check back in March-April 2026 for updated income limits based on the new Federal Poverty Guidelines, and monitor the status of the proposed $300,000 asset limit increase.