2019 Federal Poverty Level (FPL) Chart 8 2019 FINAL with FMBA

2019 MAGI MEDI-CAL FEDERAL POVERTY LEVEL (FPL) INCOME CHART

Category

Pregnant Person

Infant 0-1

Child 1-6

Child 6-19

Expansion Child 6-19

Disabled Adults 19-64

FPL

0-138% 139-213% 214-322% 0-208% 209-266% 0-142% 143-160% 161-266% 0-133% 134-160% 161-266%

108-133%

0-128%

Family Size

1

$1,437 $2,217

$3,352 $2,165

$2,769 $1,478 $1,666

2

$1,945 $3,002

$4,538 $2,932

$3,749 $2,002 $2,255

3

$2,453 $3,787

$5,724 $3,698

$4,729 $2,525 $2,844

4

$2,962 $4,571

$6,910 $4,464

$5,708 $3,048 $3,434

5

$3,470 $5,356

$8,096 $5,230

$6,688 $3,571 $4,023

6

$3,978 $6,140

$9,282 $5,996

$7,668 $4,094 $4,612

7 $4,487 $6,925 $10,468 $6,762 $8,648 $4,617 $5,202

8 $4,995 $7,709 $11,654 $7,528 $9,627 $5,140 $5,791

$2,769 $3,749 $4,729 $5,708 $6,688 $7,668 $8,648 $9,627

$1,385 $1,875 $2,365 $2,854 $3,344 $3,834 $4,324 $4,814

$1,666 $2,255 $2,844 $3,434 $4,023 $4,612 $5,202 $5,791

$2,769 $3,749 $4,729 $5,708 $6,688 $7,668 $8,648 $9,627

$1,125-$1,385 $1,522-$1,875 $1,920-$2,365 $2,318-$2,854 $2,716-$3,344 $3,114-$3,834 $3,511-$4,324 $3,909-$4,814

$1,333 $1,804 $2,276 $2,747 $3,219 $3,690 $4,162 $4,633

U.S. Citizen

M7

M9

P9

T5

P7

T4

T3

P5

T2

T1

M5

L6

Citizenship

0E

Status

(MCAP)

Undoc M8

M0

Note: Effective May 2016, all children under the age of 19 are eligible to full scope benefits due to the implementation of SB75. Children's restricted scope aid codes are no longer being used.

L7

Adults 19-64

* Parents/

Caretaker Relatives

0-138% $1,437 $1,945 $2,453 $2,962 $3,470 $3,978 $4,487 $4,995

0-109% $1,135 $1,536 $1,938 $2,339 $2,741 $3,142 $3,544 $3,945

M1

M3

M2

M4

Category

APTC

CSR

Unsubsidized Coverage (Private Insurance)

FPL

100-150%

151-200%

201-250%

251-400%

100-300%

400+%

1

$1,041-$1,562

$2,082

$2,603

$4,164

$1,041-$3,123

$4,165

2

$1,410-$2,114

$2,819

$3,523

$5,637

$1,410-$4,228

$5,638

3

$1,778-$2,667

$3,555

$4,444

$7,110

$1,778-$5,333

$7,111

Family

4

$2,146-$3,219

$4,292

Size

5

$2,515-$3,772

$5,029

$5,365 $6,286

$8,584 $10,057

$2,146-$6,438 $2,515-$7,543

$8,585 $10,058

6

$2,883-$4,324

$5,765

$7,207

$11,530

$2,883-$8,648

$11,531

7

$3,251-$4,877

$6,502

$8,128

$13,004

$3,251-$9,753

$13,005

8

$3,620-$5,429

$7,239

$9,048

$14,477

$3,620-$10,858

$14,478

Aid Code

X2

X3

X4

X1

X5

X7

* A parent/caretaker relative not receiving Medicare may be eligible to MAGI MC up to 138% of FPL.

MCP/HCR (8/2019)

AI/AN CSR Only No Income Test

X6 Page 1

2019 NON-MAGI MEDI-CAL FEDERAL POVERTY LEVEL (FPL) INCOME CHART

Family Size

TMC

185% (2nd 6 Mos)

(4/19)

Non-MAGI M/C

Maintenance Need Levels

(MMNL)

250% WDP

250% (4/19)

Medicare Savings Programs (MSP)

100% QMB 120% SLMB 135% QI-1

(3/19)

(3/19)

(3/19)

1

$1,926

$600

$2,603

$1,041

$1,249

$1,406

2

$2,607

$750**

$3,523

$1,410

$1,691

$1,903

3

$3,289

$934

$4,444

$1,778

$2,133

$2,400

4

$3,970

$1,100

$5,365

$2,146

$2,575

$2,897

5

$4,652

$1,259

$6,286

$2,515

$3,017

$3,395

6

$5,333

$1,417

$7,207

$2,883

$3,459

$3,892

7

$6,015

$1,550

$8,128

$3,251

$3,901

$4,389

8

$6,696

$1,692

$9,048

$3,620

$4,343

$4,886

9

$7,377

$1,825

$9,969

$3,988

$4,785

$5,384

10

$8,059

$1,959

Each Additional

Person

$682

**2 Adults $934

$14

2019 SSI/SSP PAYMENT STANDARDS INDEPENDENT LIVING ARRANGEMENT

INDIVIDUAL Jan-Dec 2019

Aged/Disabled Blind Disabled Minor

$931.72 $988.23 $836.15

COUPLE Jan-Dec 2019

Both Aged/ Disabled

$1,564.14

Both Blind

$1,751

One Blind/Other Aged or Disabled $1,666

$10,890

$4,356

$5,227

$5,881

$921

$369

$442

$498

2019 MEDICARE Part B PREMIUM

$135.50

2018 MEDICARE Part B PREMIUM

$134 / $130

2019 TB INCOME STANDARD

$1,627

INCOME CONVERSION

FACTOR

Weekly

x4.33

Bi-Weekly

x2.167

(every 2 weeks)

2019 SGA DISABLED $1,220

A&D FPL DEDUCTIONS Jan-Dec 2019

Individual Spouse Couple

$230 $310

2019 QMB/SLMB/QI-1 SSI Standard Allocation $386 "Any Income" Deduction $20

2019 MSP Property Limits

Individual $7,730

Couple

$11,600

2018 MSP Property Limits

Individual $7,560

Couple

$11,340

A&D

100% (4/19) $1,041 $1,410 $1,778 $2,146 $2,515 $2,883 $3,251 $3,620 $3,988 $4,356

$369

PICKLELast SSI/SSP Check Received

Between

1/18-12/18 1/17-12/17 1/16-12/16 1/15-12/15 1/14-12/14 1/13-12/13 1/12-12/12 1/11-12/11 1/10-12/10 1/09-12/09 1/08-12/08 1/07-12/07 1/06-12/06 1/05-12/05 1/04-12/04 1/03-12/03 1/02-12/02 1/01-12/01 1/00-12/00 1/99-12/99 1/98-12/98 1/97-12/97 1/96-12/96 1/95-12/95 1/94-12/94 1/93-12/93 1/92-12/92 1/91-12/91 1/90-12/90 1/89-12/89 1/88-12/88 1/87-12/87

Multiplier

0.0272 0.0463 0.0492 0.0492 0.0651 0.0789 0.0943 0.1257 0.1257 0.1257 0.1737 0.1923 0.2181 0.2489 0.2686 0.2836 0.2935 0.3114 0.3347 0.3503 0.3587 0.3718 0.3895 0.4050 0.4212 0.4359 0.4523 0.4719 0.4989 0.5214 0.5398 0.5584

AVERAGE PRIVATE PAY (To determine

Period of Ineligibility)

2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006

$9,337 $8,841 $8,515 $8,189 $8,092 $7,628 $7,549 $7,092 $6,840 $6,311 $5,698 $5,496 $5,101 $5,031

2019 SSA COLA MULTIPLIER 1.028

2019 FEDERAL BENEFIT RATE

Individual (ABD) Couple (QBD)

$771 $1,157

2019 LONG TERM CARE BUDGET FACTORS

Maintenance Need Community Spouse Resources Allowance (CSRA) Maximum Monthly Maintenance Need Allowance (MMMNA) Family Member Base Allocation (FMBA) (07/01/2019 - 06/30/2020) Home Maintenance Allowance Shared Home Maintenance Allowance

$35 $126,420

$3,161

$2,114

$209 $138

MCP/HCR (8/2019)

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