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Schedule MA-1 Medically Needy Income Standards (Non-MAGI) Persons Dependent Annual Monthly On Income 1 $4,200 $350 2 $4,700 $392 3 $5,200 $434 4 $5,700 $475 5 $6,252 $521 6 $6,876 $573 7 $7,740 $645 8 $8,508 $709 9 $9,192 $766 10 $9,912 $826 11 $10,632 $886 12 $11,352 $946 13 $12,048 $1,004 14 $12,756 $1,063 15 $13,488 $1,124 16 $14,208 $1,184 Each Additional Person $732 $61