New York Medicaid Eligibility Calculator (2026)
Child Health Plus gives New York the highest children’s limit in the country: $9,221 a month for a family of three. Adults qualify for Medicaid up to $1,836 a month.
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Eligibility checklist
Medicaid first, then Child Health Plus
Medicaid covers babies to 218% of the poverty line and older children to 149%; Child Health Plus covers them above that to 400% (405% with the disregard).[MACPAC] Pregnancy and from-conception coverage reach 218%.[MACPAC]
| Group | FPL | 1 | 2 | 3 | 4 | 6 |
|---|---|---|---|---|---|---|
| Adults 19–64 | 138% | $1,836 | $2,489 | $3,142 | $3,795 | $5,102 |
| Pregnancy | 223% | $2,966 | $4,022 | $5,077 | $6,133 | $8,244 |
| Children | 405% | $5,387 | $7,304 | $9,221 | $11,138 | $14,972 |
Above the adult line
MACPAC reported that as of July 2025 New York covered adults between 133% and 250% of the poverty line through the Essential Plan under a Section 1332 waiver.[MACPAC] We could not verify the Essential Plan’s current 2026 income rules, so the calculator does not compute them; check NY State of Health if you are just over the Medicaid line.
Postpartum
New York’s 12-month postpartum extension was approved June 13, 2023.[KFF] With pregnancy and from-conception coverage at 218%, a household of three earning up to $5,077 a month is covered during pregnancy and the year after.[MACPAC]
Applying and spend-down
NY State of Health takes Medicaid, Child Health Plus and Essential Plan applications. New York’s medically needy spend-down for older and disabled people is set at 138% of the poverty line — among the highest in the country.[MACPAC]
Worked example
A Queens family of four with a 4-year-old and a 14-year-old earns $10,500 a month. That is 381.8% of the poverty line for 4.
| Parent / caretaker | over by $6,705 | $3,795 |
| Child 1–5 | Child Health Plus | $11,138 |
| Child 6–18 | Child Health Plus | $11,138 |
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