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1 2 1 2 Presumptive Eligibility for Pregnant Consumers 223% FPL N/A 4,022 Qualified provider makes the presumptive eligibility determination. Cannot spenddown to become eligible for presumptive eligibility. Pregnant Consumers 223% FPL N/A 4,022 A woman determined eligible for Medicaid for any time during her pregnancy remains eligible for Medicaid coverage until the last day of the month in which the 60th day from the date the pregnancy ends occurs, regardless of any change in income or household size composition. If the income is above 223% FPL the A/R must spenddown to the Medicaid Income level. The baby will have guaranteed eligibility for one year. Children Under One 223% FPL 2,966 4,022 If the income is above 223% FPL the A/R may apply for CHPlus or spenddown to the Medicaid Income level. One year guaranteed eligibility if mother is in receipt of Medicaid on delivery. Eligibility can be determined in the 3 months retro to obtain the one year extension. Children Age 1 through 5 154% FPL 2,049 2,778 If income is above 154% FPL the A/R may apply for CHPlus or if chooses to spenddown, must spenddown to the Medicaid Income level. 110% FPL 1,463 1,984 154% FPL 2,049 2,778 Parents/Caretaker Relatives 138% FPL 1,836 2,489 If income is above 138% FPL the A/R may apply for Advanced Premium Tax Credit (APTC) or Essential Plan (EP) if chooses to spenddown, must spenddown to the Medicaid Level. 138% FPL 1,836 2,489 155% FPL 2,062 2,796 100% FPL 1,330 1,804 138% FPL 1,836 2,489 Family Planning Program 223% FPL 2,966 4,022 Eligibility determined using only applicant's income. Rev. 02.05.2026 No Resource Test 19 and 20 Year Olds, Living with Parents If income is above 155% FPL the A/R can apply for APTC or EP or if chooses to spenddown, must spenddown to Medicaid Income level. Single/Childless Couples and 19 and 20 Year Olds, Living Alone Single/Childless Couples (S/CCs) cannot spenddown, but can apply for APTC or EP; 19 and 20 year olds if income over 138% may apply for APTC or EP if chooses to spenddown, must spenddown to the Medicaid Income level. No Resource Test No Resource Test No Resource Test No Resource Test No Resource Test MAGI POPULATION Category Income Compared to: Household Size Resource Level Special Notes No Resource Test No Resource Test Children Age 6 through 18 If income is above 154% FPL the A/R may apply for CHPlus or if chooses to spenddown, must spenddown to the Medicaid Income level. No Resource Test No Resource Test No Resource Test No Resource Test