Work hours don't automatically disqualify you from Medicaid, but they can affect your income level

Medicaid looks at your gross monthly income, not the number of hours you work. You can work full-time, part-time, or multiple jobs and still receive Medicaid—as long as your total income stays below your state's limit. The limit varies by state and by household size, and it changes year to year. Some states set the limit at 100% of the federal poverty line; others go higher.

What matters is how much money you earn in a month, not whether you work 10 hours or 40 hours. A person working 20 hours per week at $15 per hour earns roughly $1,200 per month. A person working 40 hours per week at the same wage earns roughly $2,400 per month. The second person is more likely to exceed the income limit, depending on where they live and who else is in their household.

Key Takeaways

  • Medicaid counts your gross monthly income, not the hours you work, so you can work any number of hours as long as your income stays below your state's limit.
  • Income limits vary by state and household size, so you need to check your specific state's current threshold to know whether you stay covered.
  • Some states have work incentive programs that let you earn more money while keeping Medicaid, especially if you have a disability.
  • If your income rises above the limit, you may lose Medicaid when ready or at the end of the month, depending on your state's rules.
  • Reporting changes in your work hours or income to your state Medicaid office keeps your coverage active and prevents overpayments you would have to repay later.

How your state sets the income limit

Each state runs its own Medicaid program and sets its own income threshold. Most states use a percentage of the federal poverty line as their cutoff. For 2024, the federal poverty line for a single person is about $14,600 per year, or roughly $1,217 per month. A state that covers people at 138% of poverty would cover a single person earning up to about $1,679 per month. A state at 100% of poverty would cover someone earning up to about $1,217 per month.

Your state's website or your local Medicaid office can tell you the exact income limit for your household size. The limit is usually posted on the state health department or state Medicaid agency website. If you cannot find it online, call your county Medicaid office and ask for the current income limit for a single person, a couple, or a family of three—whatever matches your situation.

What counts as income for Medicaid

Medicaid counts gross income from wages, which means your pay before taxes are taken out. If you earn $2,000 per month before taxes, Medicaid counts $2,000, not the $1,600 you take home after withholding. Self-employment income, tips, bonuses, and overtime all count toward your monthly total.

Some income does not count. Child support you receive, certain tax refunds, and food stamps do not affect your Medicaid. Supplemental Security Income (SSI) counts as income. Social Security counts as income. Unemployment benefits count. If you are unsure whether a specific payment counts, ask your Medicaid caseworker before reporting it—getting it wrong can cause you to lose coverage or owe money back later.

Work incentive programs that protect your Medicaid

If you receive Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI), your state may offer a work incentive program that lets you earn more money while keeping Medicaid. The most common is called Medicaid Buy-In or Work Incentive Planning and information (WIPA). These programs are designed to help people with disabilities work without losing health coverage.

Under a typical Buy-In program, you can earn income above your state's normal limit and still keep Medicaid, as long as you meet other requirements (usually including a disability information). The rules are complex and vary by state. If you have a disability and are thinking about working more hours, contact your state's WIPA program or your local Medicaid office to ask whether you may have access to for a work incentive that would protect your coverage.

What happens when your income goes over the limit

If your work hours increase and your monthly income rises above your state's threshold, you will lose Medicaid coverage. The timing depends on your state. Some states end coverage when ready when income exceeds the limit. Others allow you to keep coverage through the end of the month in which you earned the extra income. A few states have a grace period of one or two months.

Once you lose Medicaid, you may be able to buy coverage through your state's health insurance marketplace, especially if your income is low enough to may have access to for a tax credit that lowers your monthly premium. You can also ask your employer whether they offer health insurance. If you lose Medicaid and cannot afford another plan, contact your local health department or 211 to learn what other low-cost options exist in your area.

Reporting changes in your work hours

You are required to report changes in your income or work situation to your state Medicaid office. If you start working more hours, get a raise, or take a second job, contact your caseworker within 10 days. Most states let you report changes online, by phone, or by mail. Failing to report can result in Medicaid paying for services you were not actually covered for, which means you could owe the money back later.

Reporting also protects you. If your income does go over the limit, your caseworker can tell you when ready so you can look for other coverage before Medicaid ends. Some states also have programs that help people transition off Medicaid when their income rises, so reporting early gives you time to explore those options.

Part-time work and Medicaid

Part-time work does not disqualify you from Medicaid as long as your total monthly income stays below your state's limit. Many people work part-time and receive Medicaid. If you work 15 hours per week at $14 per hour, you earn roughly $840 per month. In most states, that income would keep you well below the Medicaid threshold. The key is knowing your state's specific limit and doing the math on your expected monthly earnings.

If you are considering taking a part-time job and want to know whether it will affect your Medicaid, calculate your expected monthly income first. Multiply your hourly wage by the number of hours you expect to work per week, then multiply by 4.3 (the average number of weeks per month). Compare that to your state's income limit. If you are close to the limit, ask your Medicaid caseworker before you start the job so you know exactly where you stand.

Frequently Asked Questions

Can I work full-time and still have Medicaid?

Yes, if your full-time income stays below your state's limit. A full-time job at minimum wage may keep you below the threshold in many states, but a full-time job at $20 per hour likely will not. Check your state's current income limit and calculate your expected monthly earnings to know for certain.

What if I get a raise at work—will I lose Medicaid?

Only if your new income exceeds your state's limit. A small raise may not push you over. Report the raise to your Medicaid office within 10 days so they can tell you whether your coverage continues. If the raise does cause you to lose Medicaid, your caseworker can help you understand your options for other coverage.

Do I have to report a few extra hours of overtime?

Yes. Report any change in your income or work situation to your Medicaid office within 10 days. Overtime counts as income. Failing to report can result in overpayments that you would have to repay, so it is safer to report and let your caseworker tell you whether it affects your coverage.

If I work two part-time jobs, how does Medicaid count my income?

Medicaid adds together the gross income from both jobs. If you earn $600 from one job and $700 from another, Medicaid counts $1,300 total per month. Report both jobs and your combined expected monthly income to your caseworker.

Can I work more hours if I have a disability?

You may be able to through a work incentive program like Medicaid Buy-In. These programs let people with disabilities earn more while keeping Medicaid. Contact your state's WIPA program or your local Medicaid office to ask whether you may have access to.