Medicaid Work Requirements for Adults 50 to 64
Unlike SNAP, Medicaid has no special rule for older adults under 65. But many older adults will meet the rule through income or an exemption.
Short answer: Yes, the rule can apply to you. It covers adults 19 through 64 in the Medicaid adult expansion group, and there is no special exemption for older adults. It stops applying once you turn 65 or get Medicare at any age. Many people 50 to 64 qualify for another exemption, or meet the rule through income.
The rule in the law
The requirement covers people who have "attained the age of 19 and [are] under 65 years of age" and are not entitled to or enrolled in Medicare Part A or Part B (sec. 1902(xx)(9)(A)(i); 42 CFR 435.551). The law has no other age exemption.
Ways older adults often meet the rule or are exempt
- Income, including Social Security: you meet the rule for a month if your monthly income is at least $580. The CMS rule counts household income using Medicaid's usual MAGI rules, which include Social Security benefits. If you take early retirement benefits at 62, check whether they already put you over $580.
- Medicare: anyone with Medicare Part A or B is excluded, at any age. Many people on Social Security disability get Medicare after 24 months.
- Health conditions: conditions that are more common with age, such as COPD, heart disease, cancer, or kidney disease, can make you medically frail.
- Caregiving: caring for a spouse or parent with a disability, or raising a grandchild 13 or younger, is an exemption. See parents and caregivers.
- SNAP: if your household gets SNAP and you are subject to any SNAP work rule, you are exempt. SNAP's time limit now covers ages 18 to 64. See SNAP and TANF.
What proof is usually needed
Your state should find Medicare and Social Security income in its own data. For income, keep your Social Security award letter, pension statements, or pay stubs.
What to do next
- Use the free checker to see if the rule applies to you and which exemptions may fit.
- Use the calculator to see if your income already meets the $580 test.
- Read the full list of exemptions.
- Find your state guide for start dates, how to report, and who to call.
- Got a notice? You have at least 30 days to answer, and you can ask for a fair hearing. See what to do about a notice.
Frequently asked questions
Is there an age limit for Medicaid work requirements?
Yes. The rule covers adults 19 through 64. Once you turn 65, it no longer applies. There is no exemption for ages 50 to 64 alone.
Does Social Security count as income for the $580 test?
Medicaid counts household income using MAGI rules, which include Social Security benefits. If your countable monthly income is $580 or more, you meet the rule for that month.
I am 62 and get SNAP. Am I exempt from the Medicaid rule?
Likely yes. People 60 to 64 are now subject to SNAP's time limit. CMS says anyone in a SNAP household who is subject to a SNAP work rule is excluded from the Medicaid requirement, even without proving they meet SNAP's rule.
I have Medicare and Medicaid. Do I need to report hours?
No. Anyone with Medicare Part A or Part B is excluded from the requirement.