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 1/1/2012 |
Effective 1/1/2013 |
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Household Size |
Gross Income (185%) |
Net Income |
Household Size |
Gross Income (185%) |
Net Income |
Adult Included |
Adult Included |
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1 |
1,559 |
843 |
1 |
1,585 |
857 |
2 |
2,491 |
1,347 |
2 |
2,532 |
1,369 |
3 |
2,804 |
1,516 |
3 |
2,850 |
1,541 |
4 |
3,117 |
1,685 |
4 |
3,169 |
1,713 |
5 |
3,429 |
1,854 |
5 |
3,487 |
1,885 |
6 |
3,742 |
2,023 |
6 |
3,805 |
2,057 |
7 |
4,055 |
2,192 |
7 |
4,123 |
2,229 |
Each Addl. |
312 |
169 |
Each Addl. |
318 |
172 |
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 1/1/2012 |
Effective 1/1/2013 |
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Household Size |
Gross Income (185%) |
Net Income |
Household Size |
Gross Income (185%) |
Net Income |
Adult Not Included |
Adult Not Included |
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1 |
1,369 |
740 |
1 |
1,391 |
752 |
2 |
1,681 |
909 |
2 |
1,709 |
924 |
3 |
1,994 |
1,078 |
3 |
2,027 |
1,096 |
4 |
2,306 |
1,247 |
4 |
2,345 |
1,268 |
5 |
2,619 |
1,416 |
5 |
2,664 |
1,440 |
6 |
2,932 |
1,585 |
6 |
2,980 |
1,611 |
7 |
3,224 |
1,754 |
7 |
3,298 |
1,783 |
Each Addl. |
312 |
169 |
Each Addl. |
318 |
172 |
SELF-EMPLOYMENT INCOME
ANNUALIZATION STANDARDS (185% FPG )
Household Size |
Income Standard Effective 3/1/2011 |
Income Standard Effective 3/1/2012 |
Income Standard Effective 3/1/2013 |
1 |
25,160 |
25,845 |
26,548 |
2 |
34,003 |
35,002 |
35,853 |
3 |
42,846 |
44,160 |
45,159 |
4 |
51,869 |
53,317 |
54,464 |
5 |
60,532 |
62,475 |
63,770 |
6 |
69,375 |
71,632 |
73,075 |
7 |
78,218 |
80,790 |
82,381 |
8 |
87,061 |
89,947 |
91,686 |
Each Addl. |
8,843 |
9,158 |
9,306 |
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