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STATE OF DELAWARE DELAWARE HEALTH AND SOCIAL SERVICES DIVISION OF MEDICAID & MEDICAL ASSISTANCE POLICY & PLANNING UNIT ADMINISTRATIVE NOTICE A-03-2026

TO: DMMA and DSS Staff

DATE: February 4, 2026

PROGRAM(S): MAGI and Non-MAGI Medicaid, and Delaware Healthy Children Program (DHCP)

SUBJECT: 2026 Federal Poverty and Medicaid Assistance Levels

BACKGROUND

The U.S. Department of Health & Human Services, Office of the Assistant Secretary for Planning and Evaluation, announced the 2026 Federal Poverty Level (FPL) guidelines on January 16, 2026. The Centers for Medicare & Medicaid Services released the 2026 Federal Poverty Level Standards on January 23, 2026. Both guidelines are used to compute income eligibility standards for:

• Parents/Caretaker Relatives • Pregnant Women • Infants • Children • Adults • Delaware Healthy Children Program (DHCP) • Qualified Medicare Beneficiary (QMB) • Specified Low Income Medicare Beneficiary (SLMB) • Qualifying Individual 1 (QI-1) • Qualified Disabled Working Individual (QDWI)

DISCUSSION

The monthly countable income limits are effective January 1, 2026, for parents/caretaker relatives, pregnant women, infants, children, adults, the Delaware Healthy Children Program, and QDWIs.

The income limits are effective April 1, 2026, for QMBs, SLMBs, and QI-1s who have Title II income. Docusign Envelope ID: 4C24504D-3858-486F-8AB2-80022EC1F181

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• Parents/Caretaker Relatives must have family income at or below 87% of poverty. • Pregnant women and infants under age 1 must have family income at or below 212% of poverty. Pregnant women count as 2 (or more) family members. • Children age 1 through age 5 (under age 6) must have family income at or below 142% of poverty. • Children age 6 through age 18 (under age 19) must have family income at or below 133% of poverty. • Adults must have family income at or below 133% of poverty. • Children in DHCP must have income at or below 212% of poverty. • A QMB must have income at or below 100% of poverty. • A SLMB must have income at or below 120% of poverty. • A QI-1 must have income that is over 120% of poverty but does not exceed 135% of poverty. • A QDWI must have income at or below 200% of poverty. • For a family size greater than 8, add $5,680.00* to the annual income for each family member. • The 5% FPL Income Disregard is used when determining eligibility for an individual who is over income under a MAGI-based group using the highest income standard available for the individual. • The tax filing thresholds for dependents are published annually in IRS Pub 501. The thresholds are updated in ASSIST Worker Web to be effective starting in January of each year. Single dependents are required to file a tax return if any of the following apply: o Countable MAGI based unearned income more than $1,350.00 annually; o Countable MAGI based earned income more than $15,750.00 annually. o Countable MAGI based self-employment income more than $400.00 annually.

Effective July 1, 2024, Delaware Medicaid removed the premium requirement for DHCP members.

The charts below show the income limits for the various medical assistance programs. Docusign Envelope ID: 4C24504D-3858-486F-8AB2-80022EC1F181