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1 $1330.00 5 $3224.00 2 $1804.00 6 $3697.00 3 $2277.00 7 $4170.00 4 $2750.00 8 $4644.00

3010.30.10.05 INCOME STANDARDS LOW-INCOME PARENT CARETAKER

This chart lists the monthly income standards to be used for Low-Income Parent Caretakers aged between 19 and 64 (MASP and MASB) and for low-income parent caretakers who are eligible for Medicare or eligible to receive an HCBS Waiver (MAGF). Low Income Parent Caretakers refugees who are within their first 12 months in the country will be placed into MAGF instead of MA Q. These members will be able to remain in MAGF for 12 months.

AG SIZE NET INCOME STANDARD AG SIZE NET INCOME STANDARD 1 $152.00 5 $435.00 2 $247.00 6 $498.00 3 $310.00 7 $561.00 4 $373.00 8 $624.00 For each additional member, add $63.00

3010.30.10.10 INCOME STANDARDS HIP TMA

For HIP TMA adults aged at least 19 years old and less than 65 years old (MASP and MASB), refer to 3010.26.00.

3010.30.15 INCOME STANDARDS/CHILD AGE 6 - 18 (MED 3)

This chart lists the monthly income standards to be used for children 6 years old and through the age of 18 (MA 2) effective March 1, 2026. Financial eligibility exists if net income is less than or equal to the standards per AG size.11 The income standard is based on 106% of the Federal Poverty Level.

AG SIZE NET INCOME STANDARD AG SIZE NET INCOME STANDARD 1 $1410.00 5 $3417.00 2 $1912.00 6 $3919.00 3 $2414.00 7 $4421.00 4 $2915.00 8 $4922.00 For each additional member, add $502.00

3010.30.20 INCOME STANDARDS/CHILD AGE 1 - 5 (MED 3)