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MAD 029

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Revised 04/01/2026 AGED, BLIND AND DISABLED MEDICAID PROGRAMS

FEDERAL POVERTY LEVELS

HOUSEHOLD 100% 120% 135% 250% 1 $1,330.00 $1,596.00 $1,796.00 $3,325.00 2 $1,804.00 $2,164.00 $2,435.00 $4,509.00 3 $2,277.00 $2,732.00 $3,074.00 $5,692.00 4 $2,750.00 $3,300.00 $3,713.00 $6,875.00 5 $3,224.00 $3,868.00 $4,352.00 $8,059.00 6 $3,697.00 $4,436.00 $4,991.00 $9,242.00 7 $4,170.00 $5,004.00 $5,630.00 $10,425.00 8 $4,644.00 $5,572.00 $6,269.00 $11,609.00 +1 $474 $568 $639 $1,184

2026 Federal Cost of Living Adjustment is 2.8% *Resource Guidelines no longer apply to MSP Categories (QMB/SLIMB/QI1)

SSI Extensions, WDI, and IC/Waivers

Effective: 1/1/2026

SSI Extensions- DAC, Widower, 503 Lead/Pickle • Income must be below SSI FBR once disregards are deducted • FBR for SSI recipient o Individual $994 o Couple $1,491 • Resources below o Individual $2,000 o Couple $3,000 • Full coverage Medicaid category

WDI-Working Disabled • Earned income up to 250% FPL for a single and a couple • Unearned income before disregards and deductions o Single $2,007 o Couple $3,001 • Quarterly Earnings $1,890 • Full coverage Medicaid • Must be working and disabled • Being over 65 is not equivalent to being disabled. Client has to be disabled through SSA or DDU • Resources below o Individual $10,000 o Couple $15,000

IC/Waiver • Income standard $2,982 • Net income for IDTs $2,981 • Resource Limit $2,000 • Average cost of nursing facility $9,209 • MMMNA $2,643.75 (7/1/25) • Excess shelter Max $1,422.75 Min $793.13 (7/1/25) • MMMNA + Excess Shelter = $4,066.50 • CSRA-Fed Max $162,660 • CSRA-State Min $32,532 • Personal Needs Allowance $97 (7/1/25) • Trustee Fee 3% net income standard- $89.43 • Excess Home Equity for LTC Services- $752,000 Medicare Savings Programs Federal Poverty Level (FPL) Effective: 4/1/2026-3/31/2027

Qualified Medicare Beneficiary-QMB • Income up to 100% FPL • Will pay conditional Part A premium • Eligibility begins the month after the month of approval • No retroactive months Covers: • Medicare PT B Premium $202.90 (2026) • Medicare PT A Premium $565 (2026) • Medicare Co-pay amounts • Medicare deductibles: o 2026 Hospital $1,736 o 2026 Doctor $283 • Deemed LIS eligible for Medicare Part D

Specified Low Income Medicare Beneficiary (SLIMB) • Income 100%-120% FPL • Will NOT pay Conditional PT A • Eligibility begins the month of approval • Up to 3 months of retroactive coverage

Covers: • Medicare PT B Premium Only! No other benefit coverage • No Medicaid card is issued • Deemed LIS eligible for Medicare Part D

Qualified Individuals (Q1-1) • Income 120%-135% FPL • Will NOT pay for Conditional PT A • Eligibility begins the month of approval • Up to 3 months of retroactive coverage

Covers: • Medicare PT B Premium Only! No other benefit coverage • No Medicaid card issued • Deemed LIS eligible for Medicare Part D