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Effective: May 1, 2013 |
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22.05.10ar9 - 100% FPG (Archive) |
Archived: June 1, 2014 |
FPG Chart - July 1, 2013, through June 30, 2014.
FPG Chart - July 1, 2012, through June 30, 2013.
100% FPG is the maximum income allowed for the following:
l MA Method A - Children ages 19-20.
l MA Method A - Parents and relative caretakers.
l MA Method A spenddown standard.
l Refugee Medical Assistance (RMA).
Note: See Refugee Medical Assistance - Income Guidelines for information about when to apply the income limit for RMA.
l MA Method B clients who do not have a spenddown.
Note: MA Method B clients with income greater than 100% FPG must use 75% FPG to determine the medical spenddown.
l Qualified Medicare Beneficiary (QMB).
Income for the following must be greater than 100% FPG:
l Service Limited Medicare Beneficiary (SLMB).
Exception: People with incomes less than 100% FPG may receive SLMB for months before QMB is approved. See SLMB - Eligibility Begin Date.
Note: The maximum income allowed for SLMB is 120% FPG.
FPG Chart - July 1, 2013, through June 30, 2014
The figures in this chart are effective July 1, 2013, through June 30, 2014.
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100% FPG Income Standards |
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Household Size |
Monthly Standard |
6-Month Standard |
Annual Standard |
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1 |
$958 |
$5,748 |
$11,496 |
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2 |
$1,293 |
$7,758 |
$15,516 |
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3 |
$1,628 |
$9,768 |
$19,536 |
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4 |
$1,963 |
$11,778 |
$23,556 |
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5 |
$2,298 |
$13,788 |
$27,576 |
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6 |
$2,633 |
$15,798 |
$31,596 |
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7 |
$2,968 |
$17,808 |
$35,616 |
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8 |
$3,303 |
$19,818 |
$39,636 |
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9 |
$3,638 |
$21,828 |
$43,656 |
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10 |
$3,973 |
$23,838 |
$47,676 |
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Add'l |
$335 |
$2,010 |
$4,020 |
FPG Chart - July 1, 2012, through June 30, 2013
The figures in this chart are effective July 1, 2012, through June 30, 2013.
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100% FPG Income Standards |
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Household Size |
Monthly Standard |
6-Month Standard |
Annual Standard |
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1 |
$931 |
$5,586 |
$11,172 |
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2 |
$1,261 |
$7,566 |
$15,132 |
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3 |
$1,591 |
$9,546 |
$19,092 |
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4 |
$1,921 |
$11,526 |
$23,052 |
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5 |
$2,251 |
$13,506 |
$27,012 |
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6 |
$2,581 |
$15,486 |
$30,972 |
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7 |
$2,911 |
$17,466 |
$34,932 |
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8 |
$3,241 |
$19,446 |
$38,892 |
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9 |
$3,571 |
$21,426 |
$42,852 |
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10 |
$3,901 |
$23,406 |
$46,812 |
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Add'l |
$330 |
$1,980 |
$3,960 |