Medicaid Eligibility Calculator
Check Medicaid and CHIP eligibility based on your post-divorce income and household size. Compare income thresholds for adults, pregnant women, and children, and estimate your potential premium savings.
Medicaid Eligibility After Divorce
Divorce often results in a significant reduction in household income, which may make you newly eligible for Medicaid. Under the Affordable Care Act, Medicaid eligibility for most adults is determined using Modified Adjusted Gross Income (MAGI). In the 40 states (plus DC) that have expanded Medicaid, adults with income up to 138% of the Federal Poverty Level qualify for coverage with no premium.
Your post-divorce household size typically includes you and any dependents you claim on your taxes. Your ex-spouse's income is no longer counted. Child support received is not counted as income for MAGI purposes, which can significantly affect eligibility. Alimony received, however, is counted as income under MAGI rules.
If your income changes during the year due to divorce, you can apply for Medicaid at any time -- there is no enrollment period restriction. Additionally, losing health insurance coverage through a spouse qualifies you for a 60-day Special Enrollment Period on the ACA marketplace if you earn too much for Medicaid.
Coverage for Children: Medicaid and CHIP
Children have broader eligibility than adults. In most states, children qualify for Medicaid at income levels up to 100-200% of FPL, and CHIP extends coverage to families earning up to 200-300% of FPL. These programs cover doctor visits, hospital care, immunizations, prescriptions, dental care, and vision care for children under 19.
After divorce, the custodial parent's income and household size determine eligibility. Even if the non-custodial parent earns a high income, children's Medicaid/CHIP eligibility is based solely on the household where they live. This means children of divorced parents frequently qualify even when they did not qualify before the divorce.
Both Medicaid and CHIP have minimal or no premiums and very low copayments. The estimated savings compared to employer coverage or marketplace plans ranges from $6,000 to $12,000 per year for a family, making it essential to check eligibility after any major household change.
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