RFT 242 1 of 1 AD-CARE AND MEDICARE SAVINGS PROGRAM INCOME LIMITS RFB 2026-004 4-1-2026

REFERENCE TABLES MANUAL STATE OF MICHIGAN DEPARTMENT OF HEALTH & HUMAN SERVICES

AGED OR DISABLED (AD) CARE AND FULL-COVERAGE QUALIFIED MEDICARE BENEFICIARIES (QMB) MONTHLY INCOME LIMITS

TABLE 1 NUMBER IN FISCAL GROUP Effective 4/1/2025 All Clients Effective 4/1/2026 All Clients 1 $1324.00 $1350.00 2 $1783.00 $1824.00 Note: Use Table 1 to determine AD-Care (BEM 163) and full-coverage QMB (BEM 165) income eligibility. Income limits are 100 percent of the Federal Poverty Level (FPL) + $20 disregard for RSDI income.

LIMITED-COVERAGE QMB (SLM) MONTHLY INCOME LIMITS

TABLE 2 NUMBER IN FISCAL GROUP Effective 4/1/2025 All Clients Effective 4/1/2026 All Clients 1 $1325.01-1585.00 $1350.01-1616.00 2 $1783.01-2135.00 $1824.01-2184.00 Note: Use Table 2 to determine limited-coverage QMB (SLM) income eligibility; see BEM 165. Income limits are 120% of the FPL + $20 disregard for RSDI income.

ALMB MONTHLY INCOME LIMITS TABLE 3 NUMBER IN FISCAL GROUP Effective 4/1/2025 All Clients Effective 4/1/2026 All Clients 1 1585.01-1781.00 $1616.01-1816.00 2 $2135.01-2400.00 $2184.01-2455.00

Note: Use Table 3 to determine eligibility as Additional Low-Income Medicare Beneficiaries (BEM 165). Income limits are 135 percent of the FPL + $20 disregard for RSDI income.