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MEDICAL MEDICAL MEDICAL MEDICAL MEDICAL MEDICAL MEDICAL MEDICAL MEDICAL MEDICAL MAGI INCOME CHART Effective 4/1/2025 Household Size AM limit AM Limit w/Medicare 100% FPL 122% FPL 138% FPL 165% 190% 205% 1 $319 $385 $1,305 $1,592 $1,800 $2,152 $2,478 $2,674 2 $407 $496 $1,763 $2,151 $2,433 $2,909 $3,349 $3,614 3 $495 $607 $2,221 $2,710 $3,065 $3,665 $4,220 $4,553 4 $582 $716 $2,680 $3,269 $3,698 $4,421 $5,091 $5,493 5 $670 $827 $3,138 $3,828 $4,330 $5,177 $5,962 $6,432 6 $758 $938 $3,596 $4,387 $4,963 $5,934 $6,833 $7,372 7 $846 $1,049 $4,055 $4,947 $5,595 $6,690 $7,703 $8,312 8 $934 $1,160 $4,513 $5,506 $6,228 $7,446 $8,574 $9,251 Each Add +88 +111 +$458 $559 $633 $756 $871 $939 MAGI CASH GIFT COUNTABILITY TAX YEAR IRS ANNUAL EXCLUSION MAXIMUM EXCLUSIONS ALLOWED PER PERSON 2002-2005 $11,000 1 2006-2008 $12,000 1 2009-2012 $13,000 1 2013-2017 $14,000 1 2018-2021 $15,000 1 2022 $16,000 1 2023 $17,000 1 2024 $18,000 1 2025 $19,000 1 APPENDIX A INCOME RESOURCE CHARTS Division of Social Services Medical Assistance Manual 25 July MTL 06/25 MAGI INCOME CHART