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1 $2660.00 5 $6447.00 2 $3607.00 6 $7394.00 3 $4554.00 7 $8340.00 4 $5500.00 8 $9287.00 For each additional member, add $947.00

3010.35.20 QI INCOME STANDARDS (MED 4)

This chart lists the monthly income standards to be used for the QI (MA I) effective March 1, 2026. This standard is based on 185% of the Federal Poverty Levels.

AG SIZE NET INCOME STANDARD AG SIZE NET INCOME STANDARD 1 $2461.00 5 $5964.00 2 $3337.00 6 $6839.00 3 $4212.00 7 $7715.00 4 $5088.00 8 $8591.00 For each additional member, add $875.00

3040.00.00 GENERAL INCOME DISREGARD (MED 1, 4)

The general income disregard for these categories increased to $20.00.

3041.00.00 MEDICARE PART D BENCHMARK (MED 1)

The Medicare Part D Benchmark effective 01-01-26 is $38.44 (01-01-2025 was $49.58). Medicare members with income of less than 150% of the FPL receive a full subsidy for purchasing Part D prescription coverage, regardless of Medicaid status. The amount of the subsidy is what is referred to as the “benchmark;” this amount may periodically change.

The members may choose a more expensive policy and pay the difference. This additional expense is all that should be credited to their budget.

Medicare members who are over 150% of the FPL will only qualify for the subsidy after they are approved for full coverage Medicaid if they are in an institution, PACE members or on an HCBS approved waiver.

Months before Medicaid eligibility is established may be credited with the entire amount the applicant is paying for Part D coverage, if acceptably verified. The Part D Benchmark should be deducted for all months after Medicaid is approved. This means only the amount over the benchmark should be credited as an ongoing medical expense.