Medicaid income limits NY 2026: Medicaid, Child Health Plus and the Essential Plan

Medicaid income limits NY uses for each household size

New York’s 2026 limits took effect on January 1, 2026, and the Department of Health publishes them with the 5% disregard already included, so the adult limit appears as 138% of poverty.^[1][2] Converted to monthly income for one to six people, the 2026 levels are:^[3]

The state chart gives the same monthly figures (for example $1,836 for one adult and $3,142 for three) and also states the adult limit as $22,025 a year for one person.^[2] The Essential Plan figures here are the 200% column of that chart, because NY State of Health has not posted a separate 2026 Essential Plan chart that we could check.^[2]

Adults and parents: Medicaid to 138%, then the Essential Plan

Adults aged 19 to 64 and parents or caretaker relatives share the same Medicaid limit in New York: 138% of poverty, $2,489 a month for two and $3,142 for three.^[2] Young adults aged 19 or 20 who live with their parents have a higher line of 155%. Single adults and childless couples above the limit cannot spend down to qualify.^[2]

The Essential Plan, New York’s Basic Health Program, picks up adults above the Medicaid line up to 200% of poverty, along with lawfully present immigrants who cannot get Medicaid.^[4][2] A single adult earning $2,400 a month is over the Medicaid limit of $1,836 but under the Essential Plan limit of $2,660, which is the case the checker above starts with.

• 1 person: Medicaid $1,836, Essential Plan $2,660
• 2 people: Medicaid $2,489, Essential Plan $3,607
• 3 people: Medicaid $3,142, Essential Plan $4,554
• 4 people: Medicaid $3,795, Essential Plan $5,500

Why the Essential Plan is back at 200% since July 1, 2026

The Essential Plan returned to a 200% limit on July 1, 2026, when New York’s section 1332 waiver ended and the program went back to the federal Basic Health Program.^[5][4] From April 1, 2024 to June 30, 2026 the waiver had stretched eligibility to 250% of poverty. New York asked to end it in October 2025, and CMS approved the termination on March 20, 2026.^[4][5]

Enrollees in the 200–250% “EP Expansion” group lost Essential Plan eligibility on that date, and pregnant Essential Plan members moved back to Medicaid.^[4] For a single adult the cutoff is now $2,660 a month instead of the old 250% level.

Pregnancy, children and Child Health Plus

Pregnant women qualify for New York Medicaid up to 223% of poverty, and the household size counts the expected children, so a pregnant woman living alone is a household of at least two ($4,022 a month).^[2] Above 223% she may still qualify by spending down. Babies under 1 have the same 223% limit, and children aged 1 to 18 qualify up to 154% ($4,235 for a family of four).^[2][6]

Child Health Plus covers children under 19 above those Medicaid lines, with premiums that rise with income:^[6]

• No premium below about 222% of poverty: $2,953 a month for a household of one, $4,004 for two, $5,055 for three and $6,105 for four.
• $15, $30, $45 or $60 per child per month in the tiers between that and 400%.
• Full premium above 400% ($11,000 a month for four); there is no upper income limit for buying in at full price.

These Child Health Plus levels apply to applications made on or after February 17, 2026.^[6]

Seniors, blindness and disability: SSI-related Medicaid

New Yorkers who are 65 or older, blind or disabled are judged under non-MAGI rules, with an income level of $1,836 a month for one person and $2,489 for two in 2026.^[2] These cases also have a resource limit: $33,038 for one person and $44,796 for two. The household is always one or two people, and a medically needy spend-down is available to people over the income level.^[2] Working people with disabilities can use the Medicaid Buy-In (MBI-WPD) up to 250% of poverty, $3,325 for one and $4,509 for two, with the same resource levels.^[2]

How to apply and renew in New York

Adults, parents, pregnant women and children apply through NY State of Health online at nystateofhealth.ny.gov or by phone at 1-855-355-5777 (TTY 1-800-662-1220); people 65 or older, blind or disabled apply at their Local Department of Social Services.^[7] The NYS Medicaid Helpline is 1-800-541-2831.^[10]

Two coverage protections ended on July 1, 2026: twelve-month continuous coverage for MAGI adults and continuous coverage for children from birth to age six.^[8] If you are in one of those groups, report income changes and answer renewal letters on time.

2026–2027 changes for New York Medicaid

• October 1, 2026: federal Medicaid funding ended for certain lawfully present non-citizens. New York says this ends federal funding for those groups, not necessarily their coverage in New York.^[9]
• January 1, 2027: some Medicaid enrollees must show they are working, going to school, volunteering or in job training.^[10] Under the federal rule that means 80 hours a month or $580 of monthly income, and it applies to adults in the expansion group.^[11]
• From renewals on or after January 1, 2027: expansion adults renew every six months.^[12]

Official New York pages for applying and checking these figures:

• NY State of Health (apply for Medicaid, Essential Plan, Child Health Plus) 1-855-355-5777, TTY 1-800-662-1220
• How do I apply for Medicaid? New York State Department of Health
• Child Health Plus eligibility and cost premium tiers by income

For food help, see New York State food stamps. Compare New York with Ohio Medicaid income limits, Pennsylvania Medicaid income limits and Virginia Medicaid income limits, see the national food stamps income limit tables, or open the SNAP calculator.