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18.2.1 MHN Income Standards – MAGI Income Limits (w/5%) and CHIP Premium Amounts Page 2

MAGI income max with 5% -CHIP 75, UWHS, MPW POV, MHK, & AEG- FPL included and CHIP premium amounts 4 /1/2026-6/30/2026 # of Persons 1 2 3 4 5 6 7 8 9 10 11 #300% of Poverty SMHB & CHIP 75 4057 5501 6944 8388 9832 11275 12719 14163 15606 17050 18494 Premium 147 198 250 301 353 405 456 508 559 611 662 225% of Poverty CHIP 74 2993 4058 5123 6188 7253 8318 9383 10448 11513 12578 13643 Premium 60 81 102 124 144 165 187 207 229 250 270 #201% of Poverty UWHS 2740 3715 4690 5665 6641 7616 8591 9566 10541 11516 12491 #196% of Poverty MPW & MHK under 1 2674 3625 4577 5528 6479 7431 8382 9334 10285 11236 12188 185% of Poverty CHIP 73 2461 3337 4212 5088 5964 6839 7715 8591 9466 10342 11218 Premium 18 25 31 38 44 50 57 63 70 76 82 153%* of Poverty CHIP 4M 2035 2760 3484 4208 4932 5656 6381 7105 7829 8553 9277 150% of Poverty CHIP 71 & 72 1995 2705 3415 4125 4835 5545 6255 6965 7675 8385 9095 #148% of Poverty MHK 2035 2760 3484 4208 4932 5656 6381 7105 7829 8553 9277 141% of Poverty MPW HIF 1876 2543 3211 3878 4545 5213 5880 6548 7215 7882 8550 #133% of Poverty AEG 1836 2489 3142 3795 4449 5102 5755 6408 7061 7715 8368 110%* of Poverty 1463 1984 2504 3025 3546 4066 4587 5108 5628 6149 6670 MHF/MPW MHF 141 241 301 353 400 445 490 532 574 616 658 100% of Poverty (without 5%) 1330 1804 2277 2750 3224 3697 4170 4644 5117 5590 6064 *Income Ranges for CHIP 4M-Ages 1 through 5=148%-153% and ages 6 through 18=110%-153%; #=5% disregard applied at this level. # of Persons 12 13 14 15 16 17 18 19 20 21 22 #300% of Poverty SMHB & CHIP 75 19937 21381 22825 24268 25712 27156 28599 30043 31487 32930 34374 Premium 714 766 817 869 920 972 1023 1075 1126 1178 1230 225% of Poverty CHIP 74 14708 15773 16838 17903 18968 20033 21098 22163 23228 24293 25358 Premium 292 313 334 355 377 397 418 440 460 482 503 #201% of Poverty UWHS 13466 14441 15416 16391 17366 18341 19316 20291 21267 22242 23217 #196% of Poverty MPW & MHK under 1 13139 14091 15042 15993 16945 17896 18848 19799 20750 21702 22653 185% of Poverty CHIP 73 12093 12969 13845 14720 15596 16472 17347 18223 19099 19974 20850 Premium 89 95 102 108 115 121 127 134 140 147 153 153%* of Poverty CHIP 4M 10002 10726 11450 12174 12898 13623 14347 15071 15795 16519 17244 150% of Poverty CHIP 71 & 72 9805 10515 11225 11935 12645 13355 14065 14775 15485 16195 16905 #148% of Poverty MHK 10002 10726 11450 12174 12898 13623 14347 15071 15795 16519 17244 141% of Poverty MPW HIF 9217 9885 10552 11219 11887 12554 13222 13889 14556 15224 15891 #133% of Poverty AEG 9021 9674 10327 10981 11634 12287 12940 13593 14247 14900 15553 110%* of Poverty 7190 7711 8232 8752 9273 9794 10314 10835 11356 11876 12397 MHF/MPW MHF 700 742 784 826 868 910 952 994 1036 1078 1120 100% of Poverty (without 5%) 6537 7010 7484 7957 8430 8904 9377 9850 10324 10797 11270 *Income Ranges for CHIP 4M-Ages 1 through 5=148%-153% and ages 6 through 18=110%-153%; #=5% disregard applied at this level.

Revised (04/26)