Appendix A2 Family Medicaid Financial Limits 2021 | Medicaid

Georgia Division of Family and Children Services
Medicaid Policy Manual

Policy Title:

Family Medicaid Financial Limits 2021 (effective 3/01/2021)

Effective Date:

03/01/2021

Chapter:

Appendix A2

Policy Number:

Appendix A2

Previous Policy Number(s):

Updated or Reviewed in MT:

MT-64

2021 Income Limits

Percentage of the Federal Poverty Level (FPL)
Family Size	Parent / Caretaker with Children	Plus 5%	247% PCK	Plus 5%	205% Child 0-1 TMA	Plus 5%	211% P4HB	Plus 5%	149% Child 1-5	Plus 5%	133% Child 6-19	Plus 5%
1	$310	364	2652	2706	2201	2255	2265	2319	1600	1654	1428	1482
2	457	530	3586	3659	2976	3049	3063	3136	2163	2236	1931	2004
3	551	643	4521	4613	3752	3844	3862	3954	2727	2819	2434	2526
4	653	764	5455	5566	4528	4639	4660	4771	3291	3402	2938	3049
5	752	882	6390	6520	5303	5433	5458	5588	3855	3985	3441	3571
6	826	975	7324	7473	6079	6228	6257	6406	4418	4567	3944	4093
7	903	1071	8259	8427	6854	7022	7055	7223	4982	5150	4447	4615
8	970	1157	9193	9380	7630	7817	7853	8040	5546	5733	4950	5137
9	1034	1239	10127	10332	8405	8610	8651	8856	6109	6314	5453	5658
10	1113	1337	10062	10286	9181	9405	9450	9674	6673	6897	5957	6181
11	1194	1437	11996	12239	9957	10200	10248	10491	7237	7480	6460	6703
12	1244	1506	12931	13193	10732	10994	11046	11308	7801	8063	6963	7225
For each additional member, add:			$935		$776		$799		$564		$504

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

Family Size	220% PGW Newborn	Plus 5%	200% WHM	FAMILY MEDICAID MNIL
1	2362	2416	2147	208
2	3194	3267	2904	317
3	4026	4118	3660	375
4	4859	4970	4417	442
5	5691	5821	5174	508
6	6523	6672	5930	550
7	7356	7524	6687	600
8	8188	8375	7444	633
9	9020	9225	8200	667
10	9853	10077	8957	708
11	10685	10928	9714	758
12	11517	11779	10470	808
For each additional member, add:	$833		$757	(+) PER ADDITIONAL BG MEMBER 50

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

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: .56 Cents Per Mile