Medicaid Policy
Medicaid Policy
|
HH Size |
PCR |
Pregnant Woman & CM 0-5 |
CM 6-18 |
Med. Family Needy & Refugee
|
12 Month TR |
CHIP Plan B |
CHIP Plan C & UPP |
Adult Expansion |
ABD |
Medicare Cost Sharing |
TAM |
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|
MWI |
Med Needy |
QMB |
SLMB |
QI-1 |
QDWI |
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|
|
|
139% FPL |
133% FPL |
BMS Level |
185% FPL |
150% FPL |
200% FPL |
133% FPL |
250% FPL |
100% FPL |
100% FPL |
120% FPL |
135% FPL |
200% FPL |
5% FPL |
|
1 |
$438 |
$1,849 |
$1,769 |
382 |
$2,461 |
$1,995 |
$2,660 |
$1,769 |
$3,325 |
$1,330 |
$1,330 |
$1,596 |
$1,796 |
$2,660 |
$67 |
|
2 |
$544 |
$2,507 |
$2,399 |
468 |
$3,337 |
$2,705 |
$3,607 |
$2,399 |
$4,509 |
$1,804 |
$1,804 |
$2,164 |
$2,435 |
$3,607 |
$91 |
|
3 |
$678 |
$3,165 |
$3,028 |
583 |
$4,212 |
$3,415 |
$4,554 |
$3,028 |
$5,692 |
|
|
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|
4 |
$797 |
$3,823 |
$3,658 |
682 |
$5,088 |
$4,125 |
$5,550 |
$3,658 |
$6,875 |
|
|
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|
5 |
$912 |
$4,481 |
$4,288 |
777 |
$5,964 |
$4,835 |
$6,447 |
$4,288 |
$8,059 |
|
|
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|
6 |
$1012 |
$5,139 |
$4,917 |
857 |
$6,839 |
$5,545 |
$7,394 |
$4,917 |
$9,242 |
|
|
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|
7 |
$1072 |
$5,797 |
$5,547 |
897 |
$7,715 |
$6,255 |
$8,340 |
$5,547 |
$10,425 |
|
|
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|
8 |
$1132 |
$6,455 |
$6,176 |
938 |
$8,591 |
$6,965 |
$9,287 |
$6,176 |
$11,609 |
|
|
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|
9 |
$1196 |
$7,113 |
$6,806 |
982 |
$9,466 |
$7,675 |
$10,234 |
$6,806 |
$12,792 |
|
|
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|
10 |
$1257 |
$7,771 |
$7,435 |
1023 |
$10,342 |
$8,385 |
$11,180 |
$7,435 |
$13,975 |
|
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|
Social Security – Supplemental Security (SSI) Information
Full SSI for Single living alone: $994 (No State Supplement) SSI for Single receiving In-Kind Support: $662.67 (+$3.81 State Supplement) Full SSI for Couple living alone: $1,491 (+$5.60 State Supplement) SSI for Couple receiving In-kind Support: $994 (+$11.86 State Supplement)
|
|
|
Dependent Expected to be Required to File Threshold
Earned: $16,100 Unearned: $1,350 Qualifying Relative Limit: $5,300
|
|
|
Presumed Maximum Value (PMV)
Single: $351.33 Couple: $517
|
Nursing Home Personal Needs Allowance
$45 |
|
Medicare Part B Premium Amounts
$202.90
|
Standard Mileage Rate for Business
67¢ |