WIC Income Calculation Reference Sheet 2021-2022
WIC Income Calculation Reference Sheet - Updated 06/30/2021
Medicaid Provider ID (WIC) 7032402 Provider Type 98
For Participant: Medicaid # or
SS#/Birthdate
Medicaid (MA)
Verify active Medicaid number (CHAMPS, MI-
Benefit)
Supplemental Nutrition Assistance Program (Food Stamps)
Family Independence Program (FIP)
Verify Bridge Card current month deposit
888-678-8914
Conduent Customer Service 1-888-529-1693
2021-2022 WIC Annual Income Guidelines
185% Federal Poverty Level
WIC Final Policy Memorandum: #2020-4 (Publication of the 2020-2021 WIC Income Eligibility Guidelines) which was published May 26, 2020.
Family Size*
1 2 3 4 5 6
Hourly 2080 Hours
$11.45 $15.49 $19.53 $23.56 $27.60 $31.64
Weekly 52 weeks
$459 $620 $782 $943 $1,105 $1,266
Biweekly 26
weeks
$917 $1.240 $1,563 $1,886 $2,209 $2,532
Monthly 12
months
$1,986 $2,686 $3,386 $4,086 $4,786 $5,486
Annual
$23,828 $32,227 $40,626 $49,025 $57,424 $65,823
7
$35.68 $1,428 $2,855 $6,186 $74,222
8
$39.72 $1,589 $3,178 $6,886 $82,621
9
$43.75 $1,751 $3,501 $7,585 $91,020
10
$47.79 $1,912 $3,824 $8,285 $99,419
11
$51.83 $2,074 $4,147 $8,985 $107,818
12
$55.87 $2,235 $4,470 $9,685 $116,217
13
$59.91 $2,397 $4,793 $10,385 $124,616
14
$63.94 $2,558 $5,116 $11,085 $133,015
15
$67.98 $2,720 $5,439 $11,785 $141,414
16
$72.02 $2,882 $5,763 $12,485 $149,813
*Pregnant woman is counted as one + the number of Infants expected
when determining income eligibility for the Total Economic Unit
Ways to Calculate Total Annual Income Use past month (30 days) check stubs for income verification
Gross Income: Most recent IRS 1040 (Net Income for Farm and Self-Employed workers)
YTD: Divided by # weeks paid x 52 weeks
Weekly x 52 weeks
Every 2 weeks x 26 weeks
2 Checks per month 1 pay stub x 24
Monthly x 12 months
No Income: Review "No Income" questions to determine if part of another family. If not, record $0 annual income. Record Self Declared/Verification.
Adjunct Eligibility (Medicaid, Food Stamps or FIP): Verify current eligibility. Then client can self
declare income.
Sudden Change in Income:
Remember! You can use 1040 tax with W-2
Today's Income x 52 weeks
forms until the next one is filed for documentation.
For complete information about Income Eligibility Determination, please refer to MI-WIC Policies:
2.04 Income Determination
2.07 Declaration of No Income
2.05 Income Guidelines
2.08 Family Size
2.06 Adjunct Income Eligibility
2.12 Migrant Family Eligibility
Michigan Department of Health and Human Services & WIC Program Eligibility
= Adjunct Eligibility for WIC
133% MAGI
160% MAGI
185% FPL
195% MAGI 212% MAGI
MI-Child Health Insurance for Infants & Children 0-19 years
old
who don't qualify for Healthy Kids Program
Healthy Kids Program Insurance for Infants & Pregnant Women
MOMs Program/PE (Presumptive Eligibility) Insurance for Pregnant Women
not eligible for or not currently enrolled on Medicaid
WIC Supplemental Nutrition Pregnant & Breast feeding women, non-lactating women,
infants and children up to age 5.
Healthy Kids Insurance for
Children 1 to 19 years old
Healthy Michigan Plan
Adults 19-64 years
of age
Apply for Healthy Michigan Plan, Healthy Kid Program, MIChild:
Request appointment for WIC:
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