Appendix A2 Family Medicaid Financial Limits 2003

2003 Income Limits

LIM LIM RSM PgW, NB, PCK RSM CHILD 0-1, TMA, WIC RSM CHILD 1-5 RSM CHILD 6-19 FM-MNIL

BUDGET GROUP (BG) SIZE

GROSS INCOME CEILING (GIC)

STANDARD OF NEED (SON)

235% FEDERAL POVERTY LEVEL (FPL)

185% FEDERAL POVERTY LEVEL (FPL)

133% FEDERAL POVERTY LEVEL (FPL)

100% FEDERAL POVERTY LEVEL (FPL)

FAMILY MEDICAID MNIL

1

$435

235

1761

1385

996

749

208

2

659

356

2374

1869

1344

1010

317

3

784

424

2990

2353

1692

1272

375

4

925

500

3605

2837

2040

1534

442

5

1060

573

4219

3321

2388

1795

508

6

1149

621

4834

3805

2736

2057

550

7

1243

672

5450

4289

3084

2319

600

8

1319

713

6063

4773

3432

2580

633

9

1389

751

6678

5258

3781

2842

667

10

1487

804

7293

5743

4130

3104

708

11

1591

860

7908

6228

4479

3366

758

12

1635

884

8523

6713

4828

3628

808

(+) PER ADDITIONAL BG MEMBER

44

24

615

485

349

262

50

2003 RESOURCE LIMITS

LIM RESOURCE LIMIT: $1000

FAMILY MEDICAID MEDICALLY NEEDY (FM-MN) RESOURCE LIMIT

NUMBER OF INDIVIDUALS IN FM-MN BG

1

2

3

4

5

6

7

8

9

10

11

12

$ 2000

4000

4100

4200

4300

4400

4500

4600

4700

4800

4900

5000