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

Plus 5%

1355
1833
2311
2790
3268
3746
4225
4703
5182
5661
6139
6617
7097
7576
8055
8535
9014
9493

Plus 5%

2061
2789
3517
4245
4973
5701
6429
7157
7885
8613
9341
10068
10797
11525
12253
12982
13710
14438
Percentage of the Federal Poverty Level (FPL)

Family Size
Parent/ Caretaker with Children

Plus 5%

360
524
635
755
871
962
1057
1141
1222
1319
1417
1484
1552
1619
1686
1754
1821
1888
247%

PeachCare for Kids®

220% PGW

Plus 5%

2473
3346
4220
5094
5967
6840
7715
8588
9461
10336
11209
12082
12957
13831
14705
15580
16454
17328
Newborn

205%

Plus 5%

2208
2988
3768
4548
5328
6108
6888
7668
8448
9228
10008
10788
11569
12349
13129
13910
14690
15470
Child 0-1 TMA

200% WHM P4HB

Plus 5%

2012
2722
3433
4144
4854
5565
6276
6986
7697
8408
9118
9829
10541
11252
11963
12675

14097
149%

Child 1-5

133%

Plus 5%

1512
2045
2579
3114
3647
4181
4715
5249
5782
6317
6850
7384
7919
8453
8987
9522
10056
10590
Child 6-19

FAMILY MEDICAID MNIL
1 $310
2 457
3 551
4 653
5 752
6 826
7 903
8 970
9 1034
10 1113
11 1194
12 1244
13 1294
14 1344
15 1394
16 1444
17 1494
18 1544
For each additional member, add:
2423
3279
4136
4992
5848
6704
7561
8417
9273
10130
10986
11842
12699
13556
14413
15270
16127
16984

$857
2158
2921
3684
4446
5209
5972
6734
7497
8260
9022
9785
10548
11311
12074
12837
13600
14363
15126

$763
2011
2722
3433
4143
4854
5565
6275
6986
7697
8407
9118
9828
10539
11250
11961
12672
13383
14094

$711
1962
2655
3349
4042
4735
5429
6122
6815
7509
8202
8895
9589
10283
10977
11671
12365
13059
13753

$694
1462
1978
2495
3012
3528
4045
4561
5078
5594
6111
6627
7144
7661
8178
8695
9212
9729
10246

$517
1305
1766
2227
2688
3149
3610
4071
4532
4994
5455
5916
6377
6839
7301
7763
8225
8687
9149

$462
208
317
375
442
508
550
600
633
667
708
758
808
858
908
958
1008
1058
1108
(+) 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