Medicaid eligibility in New York — income limits for 2025
The number
New York State Medicaid covers pregnant women up to 223% of the federal poverty line — $57,580 annual income for a family of three in 2025.
Income limits in dollars (2025)
| Category | % FPL | Household of 1 | Household of 3 | Household of 4 |
|---|---|---|---|---|
| Pregnant women | 223% | $33,580 | $57,580 | $69,580 |
| Children 0-5 | 405% | $60,990 | $104,570 | $126,360 |
| Children 6-18 | 405% | $60,990 | $104,570 | $126,360 |
| Parents / caretakers | 138% | $20,780 | $35,630 | $43,060 |
| Expansion adults (19-64) | 138% | $20,780 | $35,630 | $43,060 |
Who qualifies and how the income limits work
New York State Medicaid uses modified adjusted gross income (MAGI) rules to test eligibility. For 2025, the thresholds for a three-person household are: pregnant women up to 223% of the federal poverty line ($57,580), children 0-5 up to 405% ($104,570), children 6-18 up to 405% ($104,570), and parents / caretaker relatives with dependents up to 138% ($35,630).
Adults 19-64 who don't fit another category qualify under Medicaid expansion up to 138% of the federal poverty line — $35,630 for a family of three. The state adopted expansion in 2014, so there is no coverage gap between the parent ceiling and ACA marketplace subsidies.
Citizenship / immigration status: US citizens and most lawfully present immigrants (with a 5-year waiting period for most categories under PRWORA) qualify if they meet the income test. Pregnant women and children may qualify in narrower circumstances under the CHIPRA 2009 state option. Assets test: no assets / resources test for MAGI-category applicants; a test applies for long-term care and non-MAGI applicants.
New York added Medicaid doula coverage statewide in March 2024 (the Bronx and Erie County ran a pilot starting 2019), reimbursing up to $1,930 per perinatal package. Ancient Song Doula Services in Brooklyn pushed for the rate to rise above the 2019 pilot's $600 cap.
For Black families
Expansion in New York extended Medicaid to adults up to 138% of the federal poverty line regardless of parental status, removing one of the biggest barriers to coverage for Black adults in physically demanding hourly-wage work. New York added Medicaid doula coverage statewide in March 2024 (the Bronx and Erie County ran a pilot starting 2019), reimbursing up to $1,930 per perinatal package. Ancient Song Doula Services in Brooklyn pushed for the rate to rise above the 2019 pilot's $600 cap.
Where to get help in New York
- Federally Qualified Health Centers in New York: every FQHC accepts Medicaid, charges on a sliding scale for the uninsured, and has certified application counselors who can help you apply or renew. See our FQHC directory for this state at /clinics/ny/.
- Medicaid-accepting providers in New York: our provider directory lets you filter to providers in this state. See /providers/ny/.
- State health profile for New York: for state-level health outcomes context (maternal mortality, infant mortality, life expectancy, uninsured rate) by race, see /health/new-york/.
- New York State Medicaid consumer help line: 1-800-541-2831 for application help, renewal questions, and general Medicaid inquiries. Ask for an interpreter if you need one; language access is required under Title VI of the Civil Rights Act.
References & primary sources
- New York State Medicaid, state Medicaid portal: https://www.health.ny.gov/health_care/medicaid/.
- KFF State Health Facts: kff.org/statedata. Medicaid income eligibility + enrollment.
- Medicaid.gov: medicaid.gov. Federal program guidance + state plan amendments.
- HHS 2025 Poverty Guidelines (Federal Register Jan 2025): aspe.hhs.gov/poverty-guidelines.
Data refreshed: