C—131 Income Limits
Revision 13-3; Effective July 1, 2013
C—131.1 Federal Poverty Level (FPL)
Revision 22-2; Effective April 1, 2022
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 (3-1-22) TP 44, 34, TA 76 |
144% FPL (3-1-22) TP 48, 33, TA 75 |
198% FPL (3-1-22) TP 40, 42, 43, 36, 35, TA 74 |
|---|---|---|---|
| 1 | $1,510 | $1,631 | $2,243 |
| 2 | $2,034 | $2,198 | $3,022 |
| 3 | $2,559 | $2,764 | $3,800 |
| 4 | $3,083 | $3,330 | $4,579 |
| 5 | $3,607 | $3,897 | $5,358 |
| 6 | $4,132 | $4,463 | $6,137 |
| 7 | $4,656 | $5,030 | $6,916 |
| 8 | $5,180 | $5,596 | $7,694 |
| 9 | $5,705 | $6,162 | $8,473 |
| 10 | $6,229 | $6,729 | $9,252 |
| 11 | $6,753 | $7,295 | $10,031 |
| 12 | $7,278 | $7,862 | $10,810 |
| 13 | $7,802 | $8,428 | $11,588 |
| 14 | $8,326 | $8,994 | $12,367 |
| 15 | $8,851 | $9,561 | $13,146 |
| For each additional person | $525 | $567 | $779 |
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 (3-1-22) TA 84 |
202% FPL (3-1-22) TA 85 |
204.2% FPL (3-20-22) TA 41 |
400% FPL (3-1-22) TA 77 |
413% FPL (3-1-22) TP 70 |
|---|---|---|---|---|---|
| 1 | $2,277 | $2,288 | $2,313 | $4,530 | $4,678 |
| 2 | $3,067 | $3,083 | $3,116 | $6,104 | $6,302 |
| 3 | $3,858 | $3,877 | $3,919 | $7,677 | $7,927 |
| 4 | $4,649 | $4,672 | $4,723 | $9,250 | $9,551 |
| 5 | $5,439 | $5,466 | $5,526 | $10,824 | $11,176 |
| 6 | $6,230 | $6,261 | $6,329 | $12,397 | $12,800 |
| 7 | $7,020 | $7,055 | $7,132 | $13,970 | $14,425 |
| 8 | $7,811 | $7,850 | $7,935 | $15,544 | $16,049 |
| 9 | $8,602 | $8,644 | $8,739 | $17,117 | $17,673 |
| 10 | $9,392 | $9,439 | $9,542 | $18,690 | $19,298 |
| 11 | $10,183 | $10,233 | $10,345 | $20,264 | $20,922 |
| 12 | $10,973 | $11,028 | $11,148 | $21,837 | $22,547 |
| 13 | $11,764 | $11,823 | $11,951 | $23,410 | $24,171 |
| 14 | $12,555 | $12,617 | $12,754 | $24,984 | $25,796 |
| 15 | $13,345 | $13,412 | $13,558 | $26,557 | $27,420 |
| For each additional person | $791 | $795 | $804 | $1,574 | $1,625 |
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 22-2; Effective April 1, 2022
TP 07
| Family Size | 185% FPL (3-1-22) TP 07 |
|---|---|
| 1 | $2,096 |
| 2 | $2,823 |
| 3 | $3,551 |
| 4 | $4,279 |
| 5 | $5,006 |
| 6 | $5,734 |
| 7 | $6,462 |
| 8 | $7,189 |
| 9 | $7,917 |
| 10 | $8,645 |
| 11 | $9,372 |
| 12 | $10,100 |
| 13 | $10,828 |
| 14 | $11,555 |
| 15 | $12,283 |
| For each additional person | $728 |
C—131.4 Standard MAGI Income Disregard
Revision 22-2; Effective April 1, 2022
|
Five Percentage Points of FPL |
|
|---|---|
| Family Size | 2022 Monthly Disregard Amount |
|
1 |
$56.65 |
|
2 |
$76.30 |
|
3 |
$96.00 |
|
4 |
$115.65 |
|
5 |
$135.30 |
|
6 |
$155.00 |
|
7 |
$174.65 |
|
8 |
$194.30 |
|
9 |
$214.00 |
|
10 |
$233.65 |
|
11 |
$253.30 |
|
12 |
$273.00 |
|
13 |
$292.65 |
|
14 |
$312.30 |
|
15 |
$332.00 |
|
For each additional person |
$19.70 |
C—131.5 IRS Monthly Income Thresholds
Revision 22-2; Effective April 1, 2022
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 |
2022 Threshold |
Apply Threshold Value in Form H1042, Modified Adjusted Gross Income (MAGI) Worksheet: Medicaid and CHIP |
|---|---|---|
| Unearned Income | $91.67 |
|
| Earned Income | $1,045.83 |
|