What Is the Income Limit for Iowa Medicaid?

The income limit for Iowa Medicaid depends on which category you fall into. Most adults ages 19 through 64 qualify if their household income is at or below 133 percent of the Federal Poverty Level, which works out to 138 percent after a built-in 5-point disregard — roughly $1,835 a month for a single person in 2026. Children, pregnant women, and people who are elderly, blind, or disabled follow different thresholds, several of them considerably higher.

Adults Ages 19 to 64

The Iowa Health and Wellness Plan, authorized under Iowa Code Chapter 249A, covers adults between 19 and 64 who are not pregnant and not enrolled in Medicare.1Iowa Legislature. Iowa Code 2026, Chapter 249A – Medical Assistance The statutory ceiling is 133 percent of the Federal Poverty Level, but federal law tacks on a 5 percentage-point income disregard, so the working number is 138 percent of the FPL.2Office of the Law Revision Counsel. 42 US Code 1396a – State Plans for Medical Assistance

For a single-person household in 2026, that comes to about $1,835 per month or roughly $22,025 per year.3U.S. Department of Health and Human Services. 2026 Poverty Guidelines – Detailed Tables Larger households get a higher ceiling. Coverage under the expansion has no premiums or cost-sharing.

Children and the Hawki Program

Children qualify at much higher incomes than adults, and the exact limit depends on age.

Infants under age 1 qualify for Medicaid or the Hawki program (Healthy and Well Kids in Iowa) at household incomes up to 375 percent of the FPL.4Health and Human Services. Medicaid Eligibility Children ages 1 through 18 qualify for Medicaid up to 167 percent of the FPL. Between 167 percent and 302 percent of the FPL, they can enroll in Hawki for medical and dental coverage.5Health and Human Services. Medicaid Income Guidelines

Hawki premiums depend on income:

  • Up to 167 percent FPL: free Medicaid coverage, no premium
  • 168 to 242 percent FPL: $10 to $20 per child per month for medical and dental
  • 243 to 302 percent FPL: $20 to $40 per child per month for medical and dental

For a family of four in 2026, 302 percent of the FPL comes to about $99,660 a year, so Hawki reaches well into middle-income households.3U.S. Department of Health and Human Services. 2026 Poverty Guidelines – Detailed Tables

Parents and Caretaker Relatives

Parents and caretaker relatives of dependent children face a much lower ceiling than other adults: roughly 44 percent of the FPL for the most basic Medicaid category. That is well below the adult expansion threshold, so some working parents whose children qualify for Medicaid will not qualify themselves. Parents in that gap may be eligible for subsidized Marketplace insurance.

Pregnant Women

Pregnancy coverage reaches household incomes up to 215 percent of the FPL, and the coverage is free.5Health and Human Services. Medicaid Income Guidelines The unborn child counts as a household member when the state sizes your household, which pulls the dollar ceiling higher. For a household of two (mother plus unborn child) in 2026, 215 percent of the FPL is approximately $3,877 per month.

Postpartum coverage now runs for 12 months after childbirth, following federal approval in early 2025.6Health and Human Services. Postpartum Coverage Updates Once you are approved during pregnancy, eligibility continues through the full postpartum year regardless of income changes.4Health and Human Services. Medicaid Eligibility

Aged, Blind, and Disabled

If you are 65 or older, blind, or living with a permanent disability, Iowa uses a different income method rather than the Modified Adjusted Gross Income (MAGI) rules that apply to most other groups. Several sub-categories exist, each with its own ceiling.

SSI-Related Medicaid

Iowans who receive Supplemental Security Income automatically qualify for Medicaid. If you do not receive SSI but your income is near the SSI federal benefit rate — $994 per month for an individual in 2026 — you may still qualify under SSI-related Medicaid categories.7Social Security Administration. SSI Federal Payment Amounts for 2026

Nursing Facility and Waiver Care: the 300 Percent Rule

For nursing facility care or a home and community-based services waiver, your income cannot exceed 300 percent of the SSI federal benefit rate. In 2026 that cap is $2,982 per month. This is 300 percent of SSI, not 300 percent of the FPL, which would be a larger figure.

If your income is above $2,982, you can still qualify by setting up a Medical Assistance Income Trust (MAIT), known elsewhere as a Miller Trust. Income directed into the trust is no longer counted when the state checks eligibility.8Health and Human Services. Medical Assistance Income Trust for Long-Term Care An attorney familiar with Medicaid planning can set one up, typically for $400 to $2,000 in legal fees.

Medicaid for Employed People with Disabilities

The Medicaid for Employed People with Disabilities (MEPD) program lets working Iowans with disabilities keep Medicaid at much higher income levels than other categories allow. There is no hard income ceiling; the premium scale extends above 1,480 percent of the FPL. If your gross monthly income is at or below 150 percent of the FPL ($1,957 per month on the current schedule), the premium is $0. Above that, monthly premiums run from $43 up to $913 depending on income.9Health and Human Services. Medicaid for Employed People with Disabilities

Asset Limits

If you apply as an adult under the Health and Wellness Plan expansion, as a pregnant woman, or for a child, Iowa does not count your assets. These MAGI-based categories look at income only.2Office of the Law Revision Counsel. 42 US Code 1396a – State Plans for Medical Assistance

Aged, blind, and disabled applicants do face an asset test. Iowa proposed raising its resource disregard to $10,000 for an individual and $21,000 for a couple, effective August 2025, through a State Plan Amendment.10Health and Human Services. Public Notice Public Comment Period for State Plan Amendment IA-25-0025 The prior limits were $2,000 for an individual and $3,000 for a couple. Your primary home and one vehicle are generally exempt regardless of value.

If Your Income Is Over the Limit: Medically Needy

Iowa’s Medically Needy program is a path for people whose income or assets are too high for regular Medicaid but who cannot afford their medical bills. You “spend down” by applying medical expenses against the gap between your income and the Medically Needy Income Level (MNIL). Once your unpaid medical bills or health insurance premiums equal or exceed that gap, Medicaid starts covering most services.11Health and Human Services. Medically Needy

The MNIL is $483 per month for a one- or two-person household and $666 per month for a four-person household. If your income is at or below the MNIL, you get Medicaid without a spend-down. Medically Needy coverage does not include nursing facility care or certain institutional placements.11Health and Human Services. Medically Needy

2026 Federal Poverty Level Figures

Every Iowa Medicaid income limit is expressed as a percentage of the FPL, so knowing the base number for your household size lets you work out your own ceiling. The 2026 monthly FPL amounts for the 48 contiguous states (which includes Iowa) are:3U.S. Department of Health and Human Services. 2026 Poverty Guidelines – Detailed Tables

  • 1 person: $1,330 per month ($15,960 per year)
  • 2 persons: $1,803 per month ($21,640 per year)
  • 3 persons: $2,277 per month ($27,320 per year)
  • 4 persons: $2,750 per month ($33,000 per year)
  • 5 persons: $3,223 per month ($38,680 per year)
  • 6 persons: $3,697 per month ($44,360 per year)
  • 7 persons: $4,170 per month ($50,040 per year)
  • 8 persons: $4,643 per month ($55,720 per year)

Multiply the FPL for your household size by the percentage for your category. A single adult at 138 percent of the FPL: $1,330 × 1.38 = $1,835 per month.

How Iowa Counts Your Income

For adults, children, pregnant women, and parents, Iowa uses the Modified Adjusted Gross Income (MAGI) standard. MAGI starts with your adjusted gross income from your federal return and adds back items like tax-exempt interest and foreign income. In practice it includes wages, self-employment earnings after business expenses, taxable retirement distributions (including IRA and 401(k) withdrawals), unemployment compensation, and taxable Social Security benefits.

Several income types are not counted under MAGI:

  • Child support payments you receive
  • Nontaxable VA benefits
  • Scholarships and grants used for tuition and qualified education expenses
  • Pre-tax 401(k) or 403(b) contributions, which are already subtracted from your W-2 wages

Household size matters as much as income because it changes which dollar figure applies. Iowa defines your MAGI household from your tax-filing unit: the filer, a spouse filing jointly, and anyone claimed as a tax dependent. A family member who lives elsewhere but appears on your tax return still counts, and a larger household means a higher income ceiling.

Aged, blind, and disabled applicants who fall outside MAGI follow a different method that looks at gross income with specific deductions, plus the asset test described above.