ADDENDUM 2

 

FAMILY MEDICAID INCOME STANDARDS

 

ADULT INCLUDED (AI)

 

The following income eligibility standards are used when the household includes at least one specified relative.  

 

NOTE:  

This chart is also used for the Under 21 category and for any case in which the specified relative is the only person included in the household.

 

 

Effective 1/1/2006

Effective 1/1/2007

Household Size

Gross Income (185%)

Net Income

Household Size

Gross Income (185%)

Net Income

Adult Included

Adult Included

1

1348

729

1

1393

753

2

2155

1165

2

2225

1203

3

2425

1311

3

2504

1354

4

2695

1457

4

2784

1505

5

2965

1603

5

3063

1656

6

3235

1749

6

3342

1807

7

3505

1895

7

3622

1958

Each Additional

270

146

Each Additional

279

151

 

 

ADULT NOT INCLUDED (ANI)

 

The following income eligibility standards are used in cases in which no specified relative is included in the household.  Household size is the total number of dependent children who are included in the household:

 

Effective 1/1/2006

Effective 1/1/2007

Household Size

Gross Income (185%)

Net Income

Household Size

Gross Income (185%)

Net Income

Adult Included

Adult Included

1

1184

640

1

1222

661

2

1454

786

2

1502

812

3

1724

932

3

1781

963

4

1994

1078

4

2060

1114

5

2264

1224

5

2340

1265

6

2534

1370

6

2619

1416

7

2804

1516

7

2898

1567

Each Additional

270

146

Each Additional

279

151

 

 

SELF-EMPLOYMENT INCOME

ANNUALIZATION STANDARDS (185% FPG Federal Poverty Guidelines)

 

Household

Size

Income Standard

Effective 4/1/2005

Income Standard

Effective 4/1/2006

Income Standard Effective 4/1/2007

1

22,108

22,663

23,625

2

29,656

30,525

31,672

3

37,204

38,388

39,720

4

44,752

46,250

47,767

5

52,300

54,113

55,815

6

59,848

61,975

63,862

7

67,396

69,838

71,910

8

74,944

77,700

79,957

Addl.

7,548

7,863

8,048

 

IRS Internal Revenue Service Mileage Allowance

Year

2005

2006

2007

Cents per Mile

40.5

44.5

48.5

 

 

TRANSITIONAL MEDICAID INCOME STANDARDS (185% FPG Federal Poverty Guidelines)

 

Household

Size

Effective

4/1/2005

Effective

4/1/2006

 Effective

4/1/2007

1

1,843

1,889

1,969

2

2,472

2,544

2,640

3

3,101

3,199

3,310

4

3,730

3,855

3,981

5

4,359

4,510

4,652

6

4,988

5,165

5,322

7

5,617

5,820

5,993

8

6,246

6,475

6,664

Addl.

629

656

671

 

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MC #34 (0407)