C-130, Medical Programs
C—131 Income Limits
Revision 13-3; Effective July 1, 2013
C—131.1 Federal Poverty Level (FPL)
Revision 23-2; Effective April 1, 2023
TP 33, TP 34, TP 35, TP 36, TP 43, TP 44, TP 48, TP 40, TP 42, TA 74, TA 75 and TA 76
| Family Size | 133% FPL (3-1-23) TP 44, 34, TA 76 | 144% FPL (3-1-23) TP 48, 33, TA 75 | 198% FPL (3-1-23) TP 40, 42, 43, 36, 35, TA 74 |
|---|---|---|---|
| 1 | $1,616 | $1,750 | $2,406 |
| 2 | $2,186 | $2,367 | $3,254 |
| 3 | $2,756 | $2,984 | $4,102 |
| 4 | $3,325 | $3,600 | $4,950 |
| 5 | $3,895 | $4,217 | $5,799 |
| 6 | $4,465 | $4,834 | $6,647 |
| 7 | $5,035 | $5,451 | $7,495 |
| 8 | $5,604 | $6,068 | $8,343 |
| 9 | $6,174 | $6,684 | $9,191 |
| 10 | $6,744 | $7,301 | $10,039 |
| 11 | $7,313 | $7,918 | $10,887 |
| 12 | $7,883 | $8,535 | $11,735 |
| 13 | $8,453 | $9,152 | $12,583 |
| 14 | $9,022 | $9,768 | $13,431 |
| 15 | $9,592 | $10,385 | $14,280 |
| For each additional person | $570 | $617 | $849 |
Note: See C-1114, Guidelines for Providing Retroactive Coverage for Children and Medical Programs, for the income limits.
TA 41, TA 84 (CHIP), TA 85 (CHIP-P), TA 77 and TP 70
| Family Size | 201% FPL (3-1-23) TA 84 | 202% FPL (3-1-23) TA 85 | 204.2% FPL (3-1-23) TA 41 | 400% FPL (3-1-23) TA 77 | 413% FPL (3-1-23) TP 70 |
|---|---|---|---|---|---|
| 1 | $2,443 | $2,455 | $2,482 | $4,860 | $5,018 |
| 2 | $3,304 | $3,320 | $3,356 | $6,574 | $6,787 |
| 3 | $4,165 | $4,185 | $4,231 | $8,287 | $8,556 |
| 4 | $5,025 | $5,050 | $5,105 | $10,000 | $10,325 |
| 5 | $5,886 | $5,916 | $5,980 | $11,714 | $12,095 |
| 6 | $6,747 | $6,781 | $6,855 | $13,427 | $13,864 |
| 7 | $7,608 | $7,646 | $7,729 | $15,140 | $15,633 |
| 8 | $8,469 | $8,511 | $8,604 | $16,854 | $17,402 |
| 9 | $9,330 | $9,377 | $9,479 | $18,567 | $19,171 |
| 10 | $10,191 | $10,242 | $10,353 | $20,280 | $20,940 |
| 11 | $11,052 | $11,107 | $11,228 | $21,994 | $22,709 |
| 12 | $11,913 | $11,972 | $12,103 | $23,707 | $24,478 |
| 13 | $12,774 | $12,838 | $12,977 | $25,420 | $26,247 |
| 14 | $13,635 | $13,703 | $13,852 | $27,134 | $28,016 |
| 15 | $14,496 | $14,568 | $14,727 | $28,847 | $29,785 |
| For each additional person | $861 | $866 | $875 | $1,714 | $1,770 |
C—131.2 Medically Needy and Parents and Caretaker Relatives Medicaid
Revision 15-4; Effective October 1, 2015
TA 31, TP 08, TP 32, TP 56 and TA 86
| - | - | TP 08, TA 31 and TA 86 | ||
|---|---|---|---|---|
| Family Size | TP 32 and TP 56 | One Parent | Two Parents | |
| 1 | $104 | $103 | N/A | |
| 2 | $216 | $196 | $161 | |
| 3 | $275 | $230 | $251 | |
| 4 | $308 | $277 | $285 | |
| 5 | $357 | $310 | $332 | |
| 6 | $392 | $356 | $367 | |
| 7 | $440 | $389 | $412 | |
| 8 | $475 | $441 | $447 | |
| 9 | $532 | $476 | $500 | |
| 10 | $567 | $527 | $535 | |
| 11 | $624 | $562 | $587 | |
| 12 | $659 | $613 | $622 | |
| 13 | $716 | $648 | $675 | |
| 14 | $751 | $700 | $710 | |
| 15 | $808 | $734 | $762 | |
| Per each additional member | $57 | $52 | $52 | |
C—131.3 Transitional Medicaid
Revision 23-2; Effective April 1, 2023
TP 07
| Family Size | 185% FPL (3-1-23) TP 07 |
|---|---|
| 1 | $2,248 |
| 2 | $3,041 |
| 3 | $3,833 |
| 4 | $4,625 |
| 5 | $5,418 |
| 6 | $6,210 |
| 7 | $7,003 |
| 8 | $7,795 |
| 9 | $8,588 |
| 10 | $9,380 |
| 11 | $10,172 |
| 12 | $10,965 |
| 13 | $11,757 |
| 14 | $12,550 |
| 15 | $13,342 |
| For each additional person | $793 |
C—131.4 Standard MAGI Income Disregard
Revision 23-2; Effective April 1, 2023
| Five Percentage Points of FPL | |
|---|---|
| Family Size | 2023 Monthly Disregard Amount |
1 | $60.75 |
2 | $82.15 |
3 | $103.60 |
4 | $125.00 |
5 | $146.45 |
6 | $167.85 |
7 | $189.25 |
8 | $210.70 |
9 | $232.10 |
10 | $253.50 |
11 | $274.95 |
12 | $296.35 |
13 | $317.75 |
14 | $339.20 |
15 | $360.60 |
| For each additional person | $21.45 |
C—131.5 IRS Monthly Income Thresholds
Revision 23-2; Effective April 1, 2023
Each year, the Internal Revenue Service (IRS) establishes income thresholds for earned and unearned income. People whose income (earned, unearned, or a combination) exceeds the federal income tax filing threshold are expected by the IRS to file a federal income tax return under federal law. The IRS monthly income thresholds are used to determine if a person’s income must be counted when calculating Modified Adjusted Gross Income (MAGI) financial eligibility, as explained in A-1341, Income Limits and Eligibility Tests, for Medical Programs, Step 3.
Determining whether a person is required to file a federal income tax return is determined by comparing the specified income types to the IRS thresholds in the following table.
| Type of Income | 2023 Threshold | Apply Threshold Value in Form H1042, Modified Adjusted Gross Income (MAGI) Worksheet: Medicaid and CHIP |
|---|---|---|
| Unearned Income | $95.83 |
|
| Earned Income | $1,079.17 |
|