Appendix A2 Family Medicaid Financial Limits 2015

Georgia State Seal

Georgia Division of Family and Children Services
Medicaid Policy Manual

Policy Title:

Family Medicaid Financial Limits 2015 (effective 04/01/2015)

Effective Date:

04/01/2015

Chapter:

Appendix A2

Policy Number:

Appendix A2

Previous Policy Number(s):

Updated or Reviewed in MT:

MT-49

2015 Income Limits

Percentage of the Federal Poverty Level (FPL)
Family Size Parent / Caretaker with Children Plus 5% 247% PCK Plus 5% 220% PGW Newborn Plus 5% 205% Child 0-1 TMA Plus 5% 200% WHM P4HB Plus 5%

1

310

360

2423

2473

2158

2208

2011

2061

1962

2012

2

457

524

3279

3346

2921

2988

2722

2789

2655

2722

3

551

635

4136

4220

3684

3768

3433

3517

3349

3433

4

653

755

4992

5094

4446

4548

4143

4245

4042

4144

5

752

871

5848

5967

5209

5328

4854

4973

4735

4854

6

826

962

6704

6840

5972

6108

5565

5701

5429

5565

7

903

1057

7561

7715

6734

6888

6275

6429

6122

6276

8

970

1141

8417

8588

7497

7668

6986

7157

6815

6986

9

1034

1222

9273

9461

8260

8448

7697

7885

7509

7697

10

1113

1319

10130

10336

9022

9228

8407

8613

8202

8408

11

1194

1417

10986

11209

9785

10008

9118

9341

8895

9118

12

1244

1484

11842

12082

10548

10788

9828

10068

9589

9829

13

1294

1552

12699

12957

11311

11569

10539

10797

10283

10541

14

1344

1619

13556

13831

12074

12349

11250

11525

10977

11252

15

1394

1686

14413

14705

12837

13129

11961

12253

11671

11963

16

1444

1754

15270

15580

13600

13910

12672

12982

12365

12675

17

1494

1821

16127

16454

14363

14690

13383

13710

13059

9729

18

1544

1888

16984

17328

15126

15470

14094

14438

13753

14097

For each additional member, add:

857

$763

$711

$694

A Budget Group of One does not exist for Parent/Caretaker with Child(ren) Medicaid or Pregnant Woman Medicaid.
Percentage of the Federal Poverty Level (FPL)
Family Size 149% Child 1-5 Plus 5% 133% Child 6-19 Plus 5% Family Medicaid MNIL

1

1462

1512

1305

1355

208

2

1978

2045

1766

1833

317

3

2495

2579

2227

2311

375

4

3012

3114

2688

2790

442

5

3528

3647

3149

3268

508

6

4045

4181

3610

3746

550

7

4561

4715

4071

4225

600

8

5078

5249

4532

4703

633

9

5594

5782

4994

5182

667

10

6111

6317

5455

5661

708

11

6627

6850

5916

6139

758

12

7144

7384

6377

6617

808

13

7661

7919

6839

7097

858

14

8178

8453

7301

7576

908

15

8695

8987

7763

8055

958

16

9212

9522

8225

8535

1008

17

10056

8687

9014

1058

1058

18

10246

10590

9149

9493

1108

For each additional member, add:

$517

$462

(+) PER ADDITIONAL BG MEMBER 50

A Budget Group of One does not exist for Parent/Caretaker with Child(ren) Medicaid or Pregnant Woman Medicaid.

2015 Resource Limits

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

FM-MN Allowable Mileage Reimbursement: 57.5 Cents Per Mile