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Income Limits
Healthy Connections (Medicaid) Program Income Charts
The Healthy Connections (Medicaid) program provides coverage under many different eligibility categories with varying income requirements. More than one income table may be applicable if more than one eligibility category appears to be appropriate.
General Hospital, Nursing Home, TEFRA/Katie Beckett and
Home and Community Based (Waiver) Services
(300% of the Federal Benefit Rate-FBR)
January 1, 2009
| Family Size | Monthly Income Limit |
| Individual | $2,022 |
| Spousal Allocation | $2,739 |
Optional State Supplementation (OSS)
January 1, 2009
| Monthly Net Income Limit: |
| $1,157 |
Aged, Blind or Disabled
100% Of Poverty Level
March 1, 2011
| Family Size | Monthly Income | Annual Income |
| 1 | $908 | $10,890 |
| 2 | $1,226 | $14,710 |
Optional Coverage For Pregnant Women And Infants
185% of Poverty Level
March 1, 2011
| Family Size | Monthly Income | Annual Income |
| 1 | $1,679 | $20,148 |
| 2 | $2,268 | $27,216 |
| 3 | $2,857 | $34,284 |
| 4 | $3,446 | $41,352 |
| 5 | $4,035 | $48,420 |
| 6 | $4,624 | $55,488 |
| 7 | $5,213 | $62,556 |
| 8 | $5,802 | $69,624 |
| Each Additional Member | $589 | $7,068 |
For each additional family member, add $7,068 to the annual income.
Divide by 12 and round up to the next whole dollar for the monthly income.
Partners for Healthy Children
COVERAGE FOR CHILDREN AGE 1 TO 19
March 1, 2011
200% of the Federal Poverty Level
| Family Size | 200% FPL |
|---|---|
| 1 | $1,815 |
| 2 | $2,452 |
| 3 | $3,089 |
| 4 | $3,725 |
| 5 | $4,362 |
| 6 | $4,999 |
| 7 | $5,635 |
| 8 | $6,272 |
| Each additional person | $637 |
For family sizes over 8, add the amount shown for each extra person to income limit for 8.
Specified Low Income Medicare Beneficiaries (SLMB) & Qualifying Individual (QI)
March 1, 2011
120% of Poverty Level
| Family Size | SLMB 120% |
QI 135% |
|---|---|---|
| 1 (Individual) | $1,089 | $1,226 |
| 2 (Couple) | $1,471 | $1,655 |
| Family Size | Monthly Income | Annual Income |
| 1 | $2,269 | $27,228 |
| 2 | $3,065 | $36,780 |
| 3 | $3,861 | $46,332 |
| 4 | $4,657 | $55,884 |
| 5 | $5,453 | $65,436 |
| 6 | $6,248 | $74,976 |
| 7 | $7,044 | $84,582 |
| 8 | $7,840 | $94,080 |
| Each Additional Member | $796 | $9,552 |
For each additional family member, add $9,350 to the annual income.
Divide by 12 and round up to the next whole dollar for the monthly income.
Low Income Families (LIF)
March 1, 2011
| Family Size | Net Income Limit |
|---|---|
| 1 | $452 |
| 2 | $608 |
| 3 | $764 |
| 4 | $920 |
| 5 | $1,076 |
| 6 | $1,231 |
| 7 | $1,387 |
| 8 | $1,543 |
Note: For family sizes over 8, add $156.00 for each extra person to the net income limit for 8.
To calculate the gross income limit, multiply the net income limit by 185%.
REGULAR FOSTER CARE MEDICAID INCOME LIMITS
November 1, 2009
| Family Size | Monthly Income Limit |
| 1 | $452 |
Breast and Cervical Cancer Program (BCCP)
(200% of the Federal Poverty Level)
March 1, 2011
| Family Size | Monthly Income | Annual Income |
| 1 | $1,815 | $21,780 |
| 2 | 2,452 | 29,424 |
| 3 | 3,089 | 37,068 |
| 4 | 3,725 | 44,700 |
| 5 | 4,362 | 52,344 |
| 6 | 4,999 | 59,988 |
| 7 | 5,635 | 67,620 |
| 8 | 6,272 | 75,264 |
| Each Additional Member | 637 | 7,644 |
For each additional family member, add $7,644 to the annual income. Divide by 12 and round up to the next whole dollar for the monthly income.
Family Planning (FP)
185% of Poverty Level
March 1, 2011
| Family Size | Monthly Income | Annual Income |
| 1 | $1,679 | $20,148 |
| 2 | $2,268 | $27,216 |
| 3 | $2,857 | $34,284 |
| 4 | $3,446 | $41,352 |
| 5 | $4,035 | $48,420 |
| 6 | $4,624 | $55,488 |
| 7 | $5,213 | $62,556 |
| 8 | $5,802 | $69,624 |
| Each Additional Member | $589 | $7,068 |
For each additional family member, add $7,068 to the annual income.
Divide by 12 and round up to the next whole dollar for the monthly income.
