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Appendix Page A-3-d COE-073- Children Age 6 to 19 HH Size 194% FPL 194% + 5% Disregard 143% FPL 143% + 5% Disregard 107% FPL (no 5% disregard) 133% FPL 133% + 5% Disregard 209% FPL 209% + 5% Disregard State Set Income Limit Limit + 5% Disregard 1 $1,950 $2,000 $1,438 $1,488 $1,076 $1,337 $1,387 $2,101 $2,151 $227 $277 2 $2,626 $2,694 $1,936 $2,004 $1,449 $1,800 $1,868 $2,829 $2,897 $306 $374 3 $3,302 $3,387 $2,434 $2,519 $1,821 $2,264 $2,349 $3,557 $3,642 $384 $469 4 $3,977 $4,080 $2,932 $3,035 $2,194 $2,727 $2,830 $4,285 $4,388 $462 $565 5 $4,653 $4,773 $3,430 $3,550 $2,567 $3,190 $3,310 $5,013 $5,133 $541 $661 6 $5,329 $5,466 $3,928 $4,065 $2,939 $3,654 $3,791 $5,741 $5,878 $619 $756 7 $6,005 $6,160 $4,426 $4,581 $3,312 $4,117 $4,272 $6,469 $6,624 $697 $852 8 $6,681 $6,853 $4,924 $5,096 $3,685 $4,580 $4,752 $7,197 $7,369 $775 $947 9 $7,356 $7,546 $5,423 $5,613 $4,058 $5,043 $5,233 $7,925 $8,115 $853 $1,043 10 $8,032 $8,239 $5,921 $6,128 $4,430 $5,507 $5,714 $8,653 $8,860 $931 $1,138 11 $8,708 $8,932 $6,419 $6,643 $4,803 $5,970 $6,194 $9,381 $9,605 $1,009 $1,233 12 $9,384 $9,626 $6,917 $7,159 $5,176 $6,433 $6,675 $10,109 $10,351 $1,087 $1,329 For more than 12, add: $373 for each additional person to increase the FPL. 13 14 15 16 17 18 19 20 $259 $277 $294 $312 $329 $346 $364 $381 HH Size 5% Disregard Amt $676 for each additional person to increase the FPL. $499 for each additional person to increase the FPL. $464 for each additional person to increase the FPL. $729 for each additional person to increase the FPL. For more than 8 persons, add $78 for each additional person to the State Set Income Limit Use the chart below for the correct 5% disregard amount to use for households with more than 12 persons. 2017 MAGI INCOME LIMITS EFFECTIVE MARCH 1, 2017 COE-088-Pregnant Women, COE-071 - Infants to Age 1, COE-029 Family Planning Waiver COE-072 - Children Age 1 to Age 6 COE-074- Children Age 6 to Age 19 COE-099 - CHIP COE-075 - Low-Income Parents & Caretaker Relatives