Medicaid Eligibility Calculator — MAGI pathways

Enter a household and see who would qualify under each MAGI eligibility pathway, using 2026 federal poverty guidelines and current per-state thresholds. Eligibility is a computed rule, not a prediction. Estimate only — not legal or benefits advice.

How this works & data sources

Method. Income is expressed as a % of the Federal Poverty Level (FPL) for the household size and state geography (the 48 contiguous states + DC, or the higher Alaska / Hawaii tables). Each MAGI pathway has an income ceiling (% FPL); you qualify for a pathway if your income is at or below its ceiling.

The 5-point disregard. Federal rules add a 5-percentage-point income disregard to the highest pathway, so the ACA "138% FPL" expansion limit is technically 133% + 5%. This tool uses the effective 138%.

Coverage gap. In the 10 non-expansion states, adults without dependent children generally have no Medicaid pathway, and those below 100% FPL fall into the "coverage gap" (too low for marketplace subsidies, ineligible for Medicaid). The tool flags this.

Scope. All four MAGI pathways (expansion adults, parents/caretakers, pregnant women, children) use exact per-state data (2026 FPL; thresholds as of July 2025). Non-MAGI pathways (aged/blind/disabled with asset tests, medically-needy spend-down) are intentionally excluded — a different ruleset, and not relevant to the adult-obesity use case this supports.

Sources: FPL — HHS ASPE 2026 Poverty Guidelines. Per-state adult & parent thresholds — MACPAC MACStats Exhibit 36; children & pregnant — MACPAC MACStats Exhibit 35 (both July 2025). Expansion status — KFF (2026). Data stamp: FPL 2026 · thresholds as of July 2025.

Built entirely on public data (HHS 2026 poverty guidelines, MACPAC MACStats, KFF). Deterministic eligibility rules engine — computed from those public rules, not predicted. Not legal advice; verify any individual determination with the state Medicaid agency.