Medicaid for people 65+ and people with disabilities

By the MedicaidCalc Editorial Team · Published October 5, 2026 · Updated October 5, 2026

If you are 65 or older, blind, or have a disability, Medicaid usually does not judge you by the MAGI percentages that apply to children and younger adults. Instead it uses rules borrowed from Supplemental Security Income (SSI): countable income after specific disregards, plus a limit on savings and other assets.^[1][6] That is why the calculator shows this group as “check with your state” and lists the pathways instead of giving a yes or no.

Pathway 1: SSI

In 2026 the federal SSI benefit rate is $994 a month for an individual and $1,491 for a couple.^[2] What receiving SSI means for Medicaid depends on how your state is set up:^[1]

• Section 1634 states (35) — Social Security’s SSI decision automatically makes you eligible for Medicaid.
• “SSI criteria” states (8: Alaska, Idaho, Kansas, Nebraska, Nevada, Oklahoma, Oregon, Utah) — the state uses SSI’s rules but you file a separate Medicaid application.
• 209(b) states (8: Connecticut, Hawaii, Illinois, Minnesota, Missouri, New Hampshire, North Dakota, Virginia) — the state may use stricter rules than SSI, set by its own standard (from about 64% to 100% of the poverty line). If such a state has no separate medically needy program it must let you “spend down” to its standard.

Pathway 2: the poverty-level option

States may cover people 65+ or disabled whose countable income is above the SSI level but no higher than 100% of the poverty line. 24 states use it, at levels from 74% to 100% (California effectively reaches 138% by disregarding income between 100% and 138%; Massachusetts uses 133% for people with disabilities).^[1] At 100% in 2026 the limit is $1,330 a month for one person in the lower 48 states.^[3]

Pathway 3: medically needy spend-down

If your income is too high, a medically needy program lets your incurred medical bills count against it until what is left is at or below the state’s medically needy income level. Those levels are low — often 15% to 40% of the poverty line, though Illinois, Minnesota, Utah and Wisconsin set them at 100% and New York at 138%. 18 states have no medically needy program for this group.^[1]

Pathway 4: the special income level for long-term care

For people who need at least 30 days of nursing-home care or home and community-based waiver services, states can raise the income limit to as much as 300% of the SSI rate — $2,982 a month in 2026.^[2] Most states use that maximum; Kansas and South Carolina, for example, publish $2,982 for 2026.^[4][5] Income above it can sometimes be placed in a qualified income trust; ask your state.

Assets

Unlike the MAGI groups, these pathways count resources such as bank accounts. South Carolina’s 2026 limit for its aged, blind and disabled program, for example, is $9,950 for one person and $14,910 for a couple.^[5] Your home, one car and personal belongings are usually excluded, but rules vary.

Medicare and Medicaid together

Many people 65+ have Medicare and qualify for Medicaid help with Medicare’s premiums and cost sharing through the Medicare Savings Programs, which have their own higher limits. Kansas, for example, lists 100%, 120% and 135% of the poverty line for its three tiers in 2026.^[4] If you are on Medicare, ask your state about these programs even if full Medicaid is out of reach.

Your state’s figures

Every state page has a “65+, blind or disabled” section with that state’s type, poverty-level and medically needy levels and long-term care limit — for example Florida, Illinois or Missouri. The percentages come from MACPAC’s February 2026 data book (2025 levels); MACPAC notes that a few states set medically needy levels by region and that couples’ limits differ.^[1]