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 |
||||
|
MWI |
Med Needy |
QMB |
SLMB |
QI-1 |
QDWI |
||||||||||
|
|
|
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 |
1813 |
1735 |
382 |
2413 |
1957 |
2609 |
1735 |
3261 |
1305 |
1305 |
1565 |
1761 |
2609 |
66 |
|
2 |
544 |
2450 |
2345 |
468 |
3261 |
2644 |
3525 |
2345 |
4407 |
1763 |
1763 |
2115 |
2380 |
3525 |
89 |
|
3 |
678 |
3087 |
2954 |
583 |
4109 |
3332 |
4442 |
2954 |
5553 |
|
|
||||
|
4 |
797 |
3725 |
3564 |
682 |
4957 |
4019 |
5359 |
3564 |
6698 |
|
|
||||
|
5 |
912 |
4362 |
4173 |
777 |
5805 |
4707 |
6275 |
4173 |
7844 |
|
|
||||
|
6 |
1012 |
4999 |
4783 |
857 |
6653 |
5394 |
7192 |
4783 |
8990 |
|
|
||||
|
7 |
1072 |
5636 |
5393 |
897 |
7501 |
6082 |
8109 |
5393 |
10136 |
|
|
||||
|
8 |
1132 |
6273 |
6002 |
938 |
8349 |
6769 |
9025 |
6002 |
11282 |
|
|
||||
|
9 |
1196 |
6910 |
6612 |
982 |
9197 |
7457 |
9942 |
6612 |
12428 |
|
|
||||
|
10 |
1257 |
7547 |
7221 |
1023 |
10044 |
8144 |
10859 |
7221 |
13573 |
|
|
||||
|
Social Security – Supplemental Security (SSI) Information
Full SSI for Single living alone: $967 (No State Supplement) SSI for Single receiving In-Kind Support: $644.67 (+$3.81 State Supplement) Full SSI for Couple living alone: $1,450 (+$5.60 State Supplement) SSI for Couple receiving In-kind Support: $966.34 (+$11.86 State Supplement)
|
|
|
Dependent Expected to be Required to File Threshold
Earned: $15,000 Unearned: $1,150 Qualifying Relative Limit: $4,400
|
|
|
Presumed Maximum Value (PMV)
Single: $342.33 Couple: $503.33
|
Nursing Home Personal Needs Allowance
$45 |
|
Medicare Part B Premium Amounts
$185
|
Standard Mileage Rate for Business
67 cents |