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Appendix A-20-1

Revise Date: 10/2019

Lottery and Gambling Winnings: Months over which Income is Counted by Income Increment

From $ Up To $ # Months Counted for Medicaid 1 79,999 1 80,000 89,999 2 90,000 99,999 3 100,000 109,999 4 110,000 119,999 5 120,000 129,999 6 130,000 139,999 7 140,000 149,999 8 150,000 159,999 9 160,000 169,999 10 170,000 179,999 11 180,000 189,999 12 190,000 199,999 13 200,000 209,999 14 210,000 219,999 15 220,000 229,999 16 230,000 239,999 17 240,000 249,999 18 250,000 259,999 19 260,000 269,999 20 270,000 279,999 21 280,000 289,999 22 290,000 299,999 23 300,000 309,999 24 310,000 319,999 25 320,000 329,999 26 330,000 339,999 27 340,000 349,999 28 350,000 359,999 29 360,000 369,999 30 370,000 379,999 31 380,000 389,999 32 390,000 399,999 33 400,000 409,999 34 410,000 419,999 35 From $ Up To $ # Months Counted for Medicaid 420,000 429,999 36 430,000 439,999 37 440,000 449,999 38 450,000 459,999 39 460,000 469,999 40 470,000 479,999 41 480,000 489,999 42 490,000 499,999 43 500,000 509,999 44 510,000 519,999 45 520,000 529,999 46 530,000 539,999 47 540,000 549,999 48 550,000 559,999 49 560,000 569,999 50 570,000 579,999 51 580,000 589,999 52 590,000 599,999 53 600,000 609,999 54 610,000 619,999 55 620,000 629,999 56 630,000 639,999 57 640,000 649,999 58 650,000 659,999 59 660,000 669,999 60 670,000 679,999 61 680,000 689,999 62 690,000 699,999 63 700,000 709,999 64 710,000 719,999 65 720,000 729,999 66 730,000 739,999 67 740,000 749,999 68 750,000 759,999 69 760,000 769,999 70