Addendum-2 Family Medicaid Income Standards

ADDENDUM 2

FAMILY MEDICAID INCOME STANDARDS

ADULT INCLUDED (AI)

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

Note:

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

Effective 1/1/2009			Effective 1/1/2010
Household Size	Gross Income (185%)	Net Income	Household Size	Gross Income (185%)	Net Income
Adult Included			Adult Included
1	1505	814	1	1505	814
2	2406	1301	2	2406	1301
3	2708	1464	3	2708	1464
4	3009	1627	4	3009	1627
5	3311	1790	5	3311	1790
6	3613	1953	6	3613	1953
7	3914	2116	7	3914	2116
Each Additional	301	163	Each Additional	301	163

ADULT NOT INCLUDED (ANI)

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

Effective 1/1/2009			Effective 1/1/2010
Household Size	Gross Income (185%)	Net Income	Household Size	Gross Income (185%)	Net Income
Adult Included			Adult Included
1	1322	715	1	1322	715
2	1624	878	2	1624	878
3	1925	1041	3	1925	1041
4	2227	1204	4	2227	1204
5	2528	1367	5	2528	1367
6	2830	1530	6	2830	1530
7	3132	1693	7	3132	1693
Each Additional	301	163	Each Additional	301	163

SELF-EMPLOYMENT INCOME

ANNUALIZATION STANDARDS (185% FPG Federal Poverty Guidelines )

Household Size	Income Standard Effective 4/1/2007	Income Standard Effective 3/1/2008	Income Standard Effective 3/1/2009
1	23,625	24,050	25,031
2	31,672	32,375	33,689
3	39,720	40,700	42,347
4	47,767	49,025	51,005
5	55,815	57,350	59,663
6	63,862	65,675	68,321
7	71,910	74,000	76,979
8	79,957	82,325	85,637
Addl.	8,048	8,325	8,658

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		MC #44 (01/10)