Every year, the federal government updates the poverty guidelines, and those numbers aren’t just for economists and policy wonks. They directly affect whether you can get health coverage through Medicaid or other assistance programs.
For 2025, the Federal Poverty Level (FPL) has ticked up slightly to reflect the rising cost of living—and that’s a big deal if you’re trying to figure out whether you or your family qualify for help.
Let’s break down what it means for you, and how state policies can make all the difference.
Guidelines
The FPL is the foundation of Medicaid eligibility. It tells states how much income a household can earn before crossing the line into ineligibility. Here’s what the 2025 guidelines look like for the 48 contiguous states and D.C.:
| Household Size | 100% FPL Annual Income |
|---|---|
| 1 | $15,650 |
| 2 | $21,150 |
| 3 | $26,650 |
| 4 | $32,150 |
| Each Additional | +$5,500 |
In Alaska and Hawaii, the numbers are higher because of higher living costs:
| Location | 1 Person | Each Additional |
|---|---|---|
| Alaska | $19,550 | +$6,880 |
| Hawaii | $17,990 | +$6,330 |
These income limits help determine who qualifies for Medicaid, but they aren’t the full story. State policies have a huge impact on what those numbers actually mean in practice.
Expansion
Thanks to the Affordable Care Act (ACA), states had the option to expand Medicaid. Many took the deal, which meant Medicaid would cover more people—specifically, low-income adults without kids who were previously excluded.
In 2025, expansion states allow individuals earning up to 138% of the FPL to qualify. That translates to:
| Household Size | 138% FPL Limit |
|---|---|
| 1 | $21,597 |
| 2 | $29,187 |
If you’re in an expansion state and your income falls below these numbers, there’s a good chance you’re eligible for Medicaid coverage. Expansion states have essentially opened the door to more people, with fewer restrictions on who qualifies.
Differences
But not all states expanded Medicaid. If you’re in a non-expansion state, the rules get tighter—especially for adults without dependents.
In these states, you may be denied coverage even if your income is way below the poverty line. That’s because eligibility is often restricted to groups like:
- Pregnant women
- Seniors
- People with disabilities
- Parents with very low incomes
If you don’t fall into one of those groups, you might be stuck without coverage—even if you’re broke. It’s one of the most frustrating gaps in the U.S. healthcare system.
Some states do offer a “Medically Needy” program. This lets people with high medical expenses qualify for Medicaid even if their income is above the limit. It’s a safety valve, but not available everywhere.
Applying
Applying for Medicaid is easier than it used to be. Most states now let you apply online through their Medicaid or health department portals. Other ways include:
- Over the phone
- In person at a local office
- By mail
You’ll need to provide documents like proof of income, residency, and Social Security numbers for household members.
It’s worth checking your state’s site or calling their Medicaid office to see exactly what’s needed, because the details can vary a lot from state to state.
Knowing where you fall in the eligibility puzzle can save you a lot of stress—and potentially thousands in medical costs. With the 2025 FPL updates and continued state-by-state differences, it’s more important than ever to check your eligibility based on where you live.
FAQs
What is the 2025 poverty level for one person?
$15,650 in the contiguous U.S. and D.C.
What is 138% of the FPL in 2025?
$21,597 for one person, $29,187 for two.
Can adults without kids get Medicaid?
Yes, but only in states that expanded Medicaid.
How do I apply for Medicaid?
Online, by phone, by mail, or in person via state Medicaid office.
Do all states have the same Medicaid rules?
No, each state sets its own eligibility based on federal guidelines.
