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Effective: July 1, 2009 |
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22.05.10ar5 - 100% FPG (Archive) |
Archived: June 1, 2010 |
FPG Chart - July 1, 2009, through June 30, 2010.
FPG Chart - July 1, 2008, through June 30, 2009.
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, 2009, through June 30, 2010
The figures in this chart are effective July 1, 2009, through June 30, 2010.
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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 |
$903 |
$5,418 |
$10,836 |
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2 |
$1,215 |
$7,290 |
$14,580 |
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3 |
$1,527 |
$9,162 |
$18,324 |
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4 |
$1,839 |
$11,034 |
$22,068 |
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5 |
$2,151 |
$12,906 |
$25,812 |
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6 |
$2,463 |
$14,778 |
$29,556 |
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7 |
$2,775 |
$16,650 |
$33,300 |
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8 |
$3,087 |
$18,522 |
$37,044 |
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9 |
$3,399 |
$20,394 |
$40,788 |
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10 |
$3,711 |
$22,266 |
$44,532 |
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Add'l |
$312 |
$1,872 |
$3,744 |
FPG Chart - July 1, 2008, through June 30, 2009
The figures in this chart are effective July 1, 2008, through June 30, 2009.
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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 |
$867 |
$5,202 |
$10,404 |
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2 |
$1,167 |
$7,002 |
$14,004 |
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3 |
$1,467 |
$8,802 |
$17,604 |
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4 |
$1,767 |
$10,602 |
$21,204 |
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5 |
$2,067 |
$12,402 |
$24,804 |
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6 |
$2,367 |
$14,202 |
$28,404 |
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7 |
$2,667 |
$16,002 |
$32,004 |
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8 |
$2,967 |
$17,802 |
$35,604 |
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9 |
$3,267 |
$19,602 |
$39,204 |
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10 |
$3,567 |
$21,402 |
$42,804 |
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Add'l |
$300 |
$1,800 |
$3,600 |