Page 1

Official source

ACA/FAMILY MEDICAID 006 Table of Standards: Breast & Cervical Cancer Treatment-Income Supersedes: ACA-FMA 006 (04/01/2025) Reference: ARM 37.82.101 & .701 Overview: To qualify for Medicaid coverage under the Montana Breast and Cervical Cancer Treatment Program (MBCCTP), the household’s countable gross earned, and unearned income cannot exceed 250 percent of the federal poverty level (FPL) standard. COMPUTATION: The following standards are effective April 1, 2026. Income Standards for MBCCTP Medicaid (250% FPL) Family Size Monthly Income Standard 1 $3,325 2 $4,508 3 $5,692 4 $6,875 5 $8,058 6 $9,242 7 $10,425 8 $11,608 9 $12,792 10 $13,975 11 $15,158 12 $16,342 13 $17,525 14 $18,708

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Page 1

Official source

ACA/FAMILY MEDICAID 006 Table of Standards: Breast & Cervical Cancer Treatment-Income Supersedes: ACA-FMA 006 (04/01/2025) Reference: ARM 37.82.101 & .701 Overview: To qualify for Medicaid coverage under the Montana Breast and Cervical Cancer Treatment Program (MBCCTP), the household’s countable gross earned, and unearned income cannot exceed 250 percent of the federal poverty level (FPL) standard. COMPUTATION: The following standards are effective April 1, 2026. Income Standards for MBCCTP Medicaid (250% FPL) Family Size Monthly Income Standard 1 $3,325 2 $4,508 3 $5,692 4 $6,875 5 $8,058 6 $9,242 7 $10,425 8 $11,608 9 $12,792 10 $13,975 11 $15,158 12 $16,342 13 $17,525 14 $18,708