Obsolete 0325 Table VII-A

Effective Date: March 1, 2024 February 28, 2025

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                      MWI Program Limits

               See 462-1

 

Household Size

Monthly Amount

250% Poverty Guideline

Annual Amount at 100% of Federal Poverty Guideline

1

$ 3,138

$ 15,060

2

$4,259

$ 20,440

3

$5,380

$25,820

4

$6,500

$31,200

5

$7,621

$36,580

6

$8,742

$41,960

7

$9,863

$47,340

8

$10,984

$52,720

For households above 8, add $5,380 for each additional person to the 100% of poverty annual amount for a family of 8. Then multiply that amount by 2.5 and divide by 12 to get the monthly 250% amount for the new household size. Round up only once at the end of the operation.

              

MWI Premium Calculation Rates

 

See Section 462-1 to determine which percentage rate to use to calculate the MWI client's premium.

Household Size

Countable Income as per 462-1

Income Limits

Premium Rate (multiply eligible client or eligible couple's income by)

1

(Client's countable income)

Over 100% but not over 110%

over $1,255 and up to  $1,381

5%

Over 110% but not over 120%

over $1,381 and up to $1,506

10%

Over 120%

over $1,506

15%

2

(Couple's countable income)

Over 100% but not over 110%

over $1,704 and up to $1,874

5%

Over 110% but not over 120%

over $1,874 and up to $2,044

10%

Over 120%

over $2,044

15%