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.  The following two tables are used for any Family Medicaid cases determined prior to 01/01/2014. Refer to the MAGI Medicaid Income Standards in Addendum 5 for cases determined after 01/01/2014.

 

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 1/1/2013

Effective 1/1/2014

Household Size

Gross Income (185%)

Net Income

Household Size

Gross Income (185%)

Net Income

Adult Included

Adult Included

1

1,585

857

1

1,607

869

2

2,532

1,369

2

2,569

1,389

3

2,850

1,541

3

2,893

1,564

4

3,169

1,713

4

3,215

1,738

5

3,487

1,885

5

3,539

1,913

6

3,805

2,057

6

3,860

2,087

7

4,123

2,229

7

4,184

2,262

Each Addl.

318

  172

Each Addl.

323

175

 

 

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 1/1/2013

Effective 1/1/2014

Household Size

Gross Income

Net Income

Household Size

Gross Income

Net Income

Adult Not Included

Adult Not Included

1

1,391

  752

1

1,411

763

2

1,709

  924

2

1,733

937

3

2,027

1,096

3

2,057

1,112

4

2,345

1,268

4

2,380

1,287

5

2,664

1,440

5

2,702

1,461

6

2,980

1,611

6

3,024

1,635

7

3,298

1,783

7

3,346

1,809

Each Addl.

318

172

Each Addl.

323

175

 

 

SELF-EMPLOYMENT INCOME

ANNUALIZATION STANDARDS (185% FPG )

 

Household

Size

Income Standard

Effective 3/1/2014

Income Standard

Effective 3/1/2015

Income Standard

Effective 4/1/2016

1

26,973

27,232

27,454

2

36,371

36,852

37,037

3

45,769

46,472

46,620

4

55,167

56,092

56,203

5

64,565

65,712

65,786

6

73,963

75,332

75,369

7

83,361

84,952

84,952

8

92,759

94,572

94,572

Each Addl.

9,398

9,620

9,620

 

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MC #68 (04/16)