Yes, grandparents can get Medicaid for their grandchildren, and the grandparent’s income usually does not stand in the way. Under federal Medicaid rules, a grandchild living with a grandparent is typically counted as a household of one for eligibility purposes, with only the child’s own income considered. Since most children have no income, they qualify easily, whether you have legal custody, court-appointed guardianship, or an informal arrangement.
Why Your Income Usually Doesn’t Count
This is the piece most grandparents get wrong before they apply. Medicaid uses a method called Modified Adjusted Gross Income (MAGI) to decide who belongs in a child’s household. For a child who does not file taxes and is not claimed as a dependent by a parent or stepparent, the household is built under “non-filer” rules. That household includes the child, the child’s own parents (biological, adoptive, or step) if they live in the home, siblings under 19 in the home, and the child’s own spouse or children. Grandparents are not on the list.1Centers for Medicare & Medicaid Services. MAGI-Based Household Income Eligibility Training Manual
Even if you claim your grandchild as a tax dependent, an exception kicks in: because a grandparent is not a biological, adoptive, or stepparent, the child defaults back to the non-filer rules. The outcome is the same. A five-year-old living with her grandmother and no parents in the home is a household of one. Add a younger sibling, and the household is two. The grandmother’s Social Security, pension, or wages don’t enter the calculation.1Centers for Medicare & Medicaid Services. MAGI-Based Household Income Eligibility Training Manual
So a grandparent earning $60,000 a year can have a grandchild who qualifies for Medicaid based on the child’s own income alone, which for most young children is zero.
When a Parent Also Lives in the Home
The picture changes if the grandchild’s biological or adoptive parent lives with you and the child. Parents living with the child are part of the child’s household under the non-filer rules, and their income counts. If both parents live in the home along with the child and one sibling, the child’s household is four, and both parents’ earnings factor in.1Centers for Medicare & Medicaid Services. MAGI-Based Household Income Eligibility Training Manual
Your income still doesn’t count in that scenario. And if the parents’ income lifts the child above Medicaid limits, CHIP covers children at higher income levels and is worth applying for.
Income Limits and Age
Children’s eligibility is measured against the federal poverty level (FPL). Every state covers children in Medicaid up to at least 133 percent of the FPL, and most extend CHIP well beyond that, sometimes up to 200, 300, or 400 percent.2Medicaid.gov. Eligibility Policy
For 2026, the federal poverty guidelines for the 48 contiguous states set annual income at 100 percent FPL as follows:3U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation. 2026 Poverty Guidelines
- Household of 1: $15,960
- Household of 2: $21,640
- Household of 3: $27,320
- Household of 4: $33,000
A grandchild living only with a grandparent is typically a household of one. At 133 percent FPL, the Medicaid income threshold for a household of one in 2026 is roughly $21,227. Most young children have no income and clear that easily. Even a teenager with a part-time job rarely earns enough to exceed the limit.
Children must generally be under 19 to qualify for Medicaid or CHIP, and they must be state residents and either U.S. citizens or in a qualifying immigration status.4Centers for Medicare & Medicaid Services. Children’s Health Insurance Program (CHIP)2Medicaid.gov. Eligibility Policy
Custody, Guardianship, or Informal Care
You can apply for Medicaid or CHIP for your grandchild whether or not you have paperwork. A parent, grandparent, guardian, or other authorized representative can submit an application.5InsureKidsNow.gov. Frequently Asked Questions Your legal status affects only a few practical details:
- With formal custody or court-appointed guardianship, you present the order and move through the application without extra questions.
- With an informal arrangement, you can still apply, but the state may ask you to sign a statement confirming the child lives with you and you provide primary care.
- If a child welfare agency placed the grandchild with you through the formal foster care system, the child generally qualifies for Medicaid automatically regardless of your income.
None of these change the household rule. As long as you are not the child’s biological, adoptive, or stepparent, your income stays out of the grandchild’s Medicaid household.
How to Apply
You have several ways in:6HealthCare.gov. Medicaid and CHIP Coverage
- Online through HealthCare.gov. If the child appears to qualify, your information is forwarded to your state agency, which contacts you about enrollment.
- Directly through your state Medicaid agency. Most states have online portals and also accept paper applications by mail or in person.
- By phone at 1-877-KIDS-NOW (1-877-543-7669), which connects you to your state’s program.7InsureKidsNow.gov. InsureKidsNow.gov Home
Have this ready:
- The child’s full name, date of birth, and Social Security number if the child has one
- Proof of citizenship or immigration status: birth certificate, passport, or immigration documents
- Proof of state residency: a utility bill, lease, or mail addressed to you at home
- Income information for anyone included in the child’s MAGI household (in a grandparent-only case, often just the child’s, which is usually zero)
- Custody or guardianship documents if you have them; they are not required to apply
What Happens After You Apply
State agencies have up to 45 days to process a Medicaid application, or 90 days if the application is based on disability.8eCFR. Title 42 CFR 435.912 – Timeliness Standards Many decisions come faster when documentation is complete upfront. If your grandchild had medical expenses in the months before you applied, Medicaid may cover them retroactively for up to three months, subject to state waivers that shorten this window in some places.9MACPAC. Medicaid Retroactive Eligibility – Changes Under Section 1115 Waivers
Once enrolled, the child keeps coverage for a full 12 months regardless of any change in income or circumstances during that period. This 12-month continuous eligibility rule for children under 19 became a federal mandate effective January 1, 2024, and applies to both Medicaid and CHIP.10Medicaid.gov. Continuous Eligibility for Medicaid and CHIP Coverage Renewal comes once a year. The state first tries to renew automatically using data it already has; if it cannot, it sends a pre-filled form you must return within at least 30 days.11eCFR. Title 42 CFR – Redeterminations of Medicaid Eligibility Missing that deadline is a common reason children lose coverage. Watch the mail around the anniversary of enrollment.
If the application is denied, you have the right to a fair hearing. The deadline to request one ranges from 30 to 90 days depending on the state, and the denial letter itself explains how to request the hearing.12Medicaid.gov. Understanding Medicaid Fair Hearings If you believe the state counted your income when it shouldn’t have, a hearing is worth pursuing.
If the Grandchild Needs Care Right Now
Some states offer presumptive eligibility. Under this program, hospitals, clinics, schools, and other qualified organizations can screen a child on the spot and enroll the child in temporary Medicaid while the full application is processed.13Medicaid.gov. Presumptive Eligibility Not every state or provider participates, but it is worth asking if you are facing an urgent medical need.
Immigrant Grandchildren
Lawfully present noncitizens who entered the U.S. after August 22, 1996, are generally subject to a five-year waiting period before receiving federally funded Medicaid. The Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA) lets states cover lawfully residing children under 21 and pregnant women in Medicaid and CHIP without that wait, and a majority of states have taken up the option.14Congress.gov. Children’s Health Insurance Program Reauthorization Act of 2009 Refugees, asylees, and certain other humanitarian groups are exempt from the waiting period regardless of state choice.
Enrolling a grandchild in Medicaid or CHIP does not create a public charge problem for anyone in the household. Federal policy excludes CHIP and most Medicaid benefits from public charge determinations, and benefits received by family members other than the applicant are not considered at all.15USCIS. Public Charge Resources
Coverage for You as the Grandparent
Grandparents raising grandchildren may also qualify for their own Medicaid as a “caretaker relative.” Federal regulations define that as someone related to a dependent child by blood, adoption, or marriage who lives with the child and has primary responsibility for the child’s care.16Medicaid.gov. Implementation Guide – Parents and Other Caretaker Relatives In states that expanded Medicaid under the Affordable Care Act, adults with income up to 133 percent of the FPL can qualify. In states that did not expand, thresholds vary and are often lower. It’s a separate application from the child’s, but worth asking about at the same time.