615 Income Standards

 

 

Revised 01/21/2021

Policy

This manual section provides the Federal standards that are used for the eligibility determinations.

NOTE          Generally, the Federal Benefit Rate (FBR) standards change in January each year, and the Federal Poverty Level (FPL) standards change no later than  April each year.

 

1)    ALTCS Standards

The table below provides the FBR amounts for 2019, 2020 and 2021:

 

Effective 1/1/2019 to 12/31/2019

Effective 1/1/2020 to 12/31/2020

Effective 1/1/2021 to 12/31/2021

Individual (100% FBR)

$771.00

$783.00

$794.00

Couple (100% FBR)

$1,157.00

$1,175.00

$1,191.00

Individual (300% of the FBR)

$2,313.00

$2,349.00

$2,382.00

 

2)    SSI-MAO Standards

Income eligibility for SSI-MAO can be determined either under FBR or FPL income limits.  A person’s monthly income must not exceed the appropriate income limits as set below:

100% of FBR

 

Effective 1/1/2019 to 12/31/2019

Effective 1/1/2020 to 12/31/2020

Effective 1/1/2021 to 12/31/2021

Individual

$771.00

$783.00

$794.00

Couple

$1,157.00

$1,175.00

$1,191.00

 

100% of FPL

 

Effective 2/1/2019

Effective 2/1/2020

Effective 2/1/2021

Individual

$1,041.00

$1,064.00

$1,074.00

Couple

$1,410.00

$1,437.00

$1,452.00

 

3)    QMB Income Standards

Monthly income must not exceed the appropriate percentage of the FPL below:

100% of FPL

 

Effective 2/1/2019

Effective 2/1/2020

Effective 2/1/2021

Individual

$1,041.00

$1,064.00

$1,074.00

Couple

$1,410.00

$1,437.00

$1,452.00

 

4)    SLMB Income Standards

Monthly income must not exceed the appropriate percentage of the FPL below:

Greater than 100%, Equal to or Less than 120% of FPL

 

Effective 2/1/2019

Effective 2/1/2020

Effective 2/1/2021

Individual

$1,041.01- $1,249.00

$1,064.01-$1,276.00

$1,074.01-$1,288.00

Couple

$1,410.01- $1,691.00

$1,437.01-$1,724.00

$1,452.01-$1,742.00

 

5)    QI-1 Income Standards

Monthly income must not exceed the appropriate percentage of the FPL below:

Greater than 120%, Equal to or Less than 135% of the FPL

 

Effective 2/1/2019

Effective 2/1/2020

Effective 2/1/2021

Individual

$1,249.01- $1,406.00

$1,276.01-$1,436.00

$1,288.01-$1,449.00

Couple

$1,691.01- $1,903.00

$1,724.01-$1,940.00

$1,742.01-$1,960.00

 

6)    AHCCCS FTW Income Standards

Monthly income must not exceed the appropriate percentage of the FPL below:

250% of FPL

Number of People in Household

Effective 2/1/2019

Effective 2/1/2020

Effective 2/1/2021

1

$2,603.00

$2,659.00

$2,684.00

 

7)    Adult Group Income Limits

Monthly income must not exceed the appropriate percentage of the FPL below:

133% of the FPL

Number of People in Household

Effective 2/1/2019

Effective 2/1/2020

Effective 2/1/2021

1

$1,385

$1,415

$1,428

2

$1,875

$1,911

$1,931

3

$2,365

$2,408

$2,434

4

$2,854

$2,904

$2,938

5

$3,344

$3,401

$3,441

6

$3,834

$3,897

$3,944

7

$4,324

$4,394

$4,447

*Each additional member add:

$490

$497

$504

*“Each additional” approximate amounts only.

 

8)    Caretaker Relative Group Income Limits

Monthly income must not exceed the appropriate percentage of the FPL below:

106% of the FPL

Number of People in Household

Effective 2/1/2019

Effective 2/1/2020

Effective 2/1/2021

1

$1,104

$1,128

$1,138

2

$1,494

$1,523

$1,539

3

$1,885

$1,919

$1,940

4

$2,275

$2,315

$2,341

5

$2,666

$2,711

$2,742

6

$3,056

$3,106

$3,143

7

$3,446

$3,502

$3,544

*Each additional member add:

$390

$396

$402

*“Each additional” approximate amounts only.

 

9)    Pregnant Woman Group Income Limits

Monthly income must not exceed the appropriate percentage of the FPL below:

156% of the FPL

Number of People in Household

Effective 2/1/2019

Effective 2/1/2020

Effective 2/1/2021

1

$1,624

$1,659

$1,675

2

$2,199

$2,242

$2,265

3

$2,773

$2,824

$2,855

4

$3,348

$3,406

$3,445

5

$3,923

$3,989

$4,036

6

$4,497

$4,571

$4,626

7

$5,072

$5,154

$5,216

*Each additional member add:

$575

$583

$591

*“Each additional” approximate amounts only.

 

10) Child Under Age 1 Group Income Limits

Monthly income must not exceed the appropriate percentage of the FPL below:

147% of the FPL

Number of People in Household

Effective 2/1/2019

Effective 2/1/2020

Effective 2/1/2021

1

$1,531

$1,564

$1,578

2

$2,072

$2,112

$2,134

3

$2,613

$2,661

$2,691

4

$3,155

$3,210

$3,247

5

$3,696

$3,759

$3,803

6

$4,238

$4,308

$4,359

7

$4,779

$4,856 $4,915

*Each additional member add:

$541

$549

$557

*“Each additional” approximate amounts only.

 

11) Child Age 1 through 5 Group Income Limits

Monthly income must not exceed the appropriate percentage of the FPL below:

141% of the FPL

Number of People in Household

Effective 2/1/2019

Effective 2/1/2020

Effective 2/1/2021

1

$1,468

$1,500

$1,514

2

$1,987

$2,026

$2,047

3

$2,507

$2,553

$2,581

4

$3,026

$3,079

$3,114

5

$3,545

$3,605

$3,648

6

$4,065

$4,132

$4,181

7

$4,584

$4,658

$4,715

*Each additional member add

$519

$527

$534

*“Each additional” approximate amounts only.

 

12) Child Age 6 through 18 Group Income Limits

Monthly income must not exceed the appropriate percentage of the FPL below:

133% of the FPL

Number of People in Household

Effective 2/1/2019

Effective 2/1/2020

Effective 2/1/2021

1

$1,385

$1,415

$1,428

2

$1,875

$1,911

$1,931

3

$2,365

$2,408

$2,434

4

$2,854

$2,904

$2,938

5

$3,344

$3,401

$3,441

6

$3,834

$3,897

$3,944

7

$4,324

$4,394

$4,447

*Each additional member add:

$490

$497

$504

*“Each additional” approximate amounts only.

 

13) KidsCare Income Limits

Monthly income must not exceed the appropriate percentage of the FPL below:

200% of the FPL

Number of People in Household

Effective 2/1/2019

Effective 2/1/2020

Effective 2/1/2021

1

$2,082

$2,127

$2,147

2

$2,819

$2,874

$2,904

3

$3,555

$3,620

$3,660

4

$4,292

$4,367

$4,417

5

$5,029

$5,114

$5,174

6

$5,765

$5,860

$5,930

7

$6,502

$6,607

$6,687

*Each additional member add

$737

$747

$757

*“Each additional” approximate amounts only.

 

14) Transitional Medical Assistance (TMA) Income Limit (2nd 6-month period)

Monthly income must not exceed the appropriate percentage of the FPL below:

185% of the FPL

Number of People in Household

Effective 2/1/2019

Effective 2/1/2020

Effective 2/1/2021

1

$1,926

$1,968

$1,986

2

$2,607

$2,658

$2,686

3

$3,289

$3,349

$3,386

4

$3,970

$4,040

$4,086

5

$4,652

$4,730

$4,786

6

$5,333

$5,421

$5,486

7

$6,015

$6,112

$6,186

*Each additional member add

$681

$691

$700

“Each additional” approximate amounts only.

 

15)  MAGI Gap Filling Test Income Limits

If income exceeds the amounts listed for the MAGI groups in 7) through 14) above, a second income test is run using Premium Tax Credit budget group and income rules.

Monthly income must not exceed the appropriate percentage of the FPL below:

100% of the FPL

Number of People in Household

Effective 2/1/2019

Effective 2/1/2020

Effective 2/1/2021

1

$1,041

$1,064

$1,074

2

$1,410

$1,437

$1,452

3

$1,778

$1,810

$1,830

4

$2,146

$2,184

$2,209

5

$2,515

$2,557

$2,587

6

$2,883

$2,930

$2,965

7

$3,251

$3,304

$3,344

*Each additional member add

$368

$374

$379

“Each additional” approximate amounts only.

 

Definitions

Term

Definition

Federal Benefit Rate (FBR)

The basic benefit amount the Social Security Administration (SSA) pays to clients who are eligible for the Supplemental Security Income (SSI) program. 

Federal Poverty Level (FPL)

A measure of income used to help government agencies determine eligibility levels for public assistance programs such as Medicaid. 

 

Legal Authority

This requirement applies to the following programs:

Program

Legal Authorities

ALTCS

SSI-MAO

Medicare Savings Program (MSP)

Freedom to Work (FTW)

42 USC 1396a(a)(10)(E)

AAC R9-22-1504 and 1505

AAC R9-22-1909

AAC R9-28-408

AAC R9-29-212 and 213

Adult

Caretaker Relative

Pregnant Woman

Child

42 CFR 435.110, 116, 118 and 119

AAC R9-22-1427

KidsCare

42 CFR 457.10, 300, 301 and 315

AAC R9-31-304