An official State of Texas website.
Revision 24-2; Effective March 1, 2024
Fiscal Year 2024 Worksheet
| Persons in Family/Household | 100% FPL Monthly $0 Copay | 133% FPL Monthly Up to $10 Copay | 150% FPL Monthly Up to $20 Copay | 185% FPL Monthly Up to $25 Copay | 200% FPL Monthly Up to $30 Copay |
|---|---|---|---|---|---|
| 1 | $1,255 | $1,670 | $1,883 | $2,322 | $2,510 |
| 2 | $1,704 | $2,266 | $2,555 | $3,152 | $3,407 |
| 3 | $2,152 | $2,862 | $3,228 | $3,981 | $4,304 |
| 4 | $2,600 | $3,458 | $3,900 | $4,810 | $5,200 |
| 5 | $3,049 | $4,055 | $4,573 | $5,640 | $6,097 |
| 6 | $3,497 | $4,651 | $5,245 | $6,469 | $6,994 |
| 7 | $3,945 | $5,247 | $5,918 | $7,299 | $7,890 |
| 8 | $4,394 | $5,844 | $6,590 | $8,128 | $8,787 |
| 9 | $4,842 | $6,440 | $7,263 | $8,958 | $9,684 |
| 10 | $5,290 | $7,036 | $7,935 | $9,787 | $10,580 |
| 11 | $5,739 | $7,632 | $8,608 | $10,616 | $11,477 |
| 12 | $6,187 | $8,229 | $9,280 | $11,446 | $12,374 |
| Extra* | $449 | $597 | $673 | $830 | $897 |
*For families and households with more than 12 persons, add Extra for each additional person.
Note: No copay can be charged for a household below 100% FPL.
The contractor must waive the fee if a client self-declares an inability to pay. No client shall be denied services based on an inability to pay. If a copay is charged, it may not exceed $30 or the cost of the visit or encounter, whichever is less. The FPL is calculated and published annually each calendar year at HHS FPL Guidelines.