Page 20

Page | 18 D. ABD Medically Needy Income Chart Name: Aged, Blind, Disabled (ABD) Medically Needy Effective Date: July 2026 Group I Income Chart Family Unit Size 7/1/25-6/30/26 Semi-annual 7/1/25-6/30/26 Monthly 7/1/26 Semi-annual 7/1/26 Monthly 1 $2,460.34 $410.05 $2,531.64 $421.94 2 $3,132.06 $522.01 $3,214.38 $535.73

Group II Income Chart Family Unit Size 7/1/25-6/30/26 Semi-annual 7/1/25-6/30/26 Monthly 7/1/26 Semi-annual 7/1/26 Monthly 1 $ 2,838.87 $ 473.14 $2,913.53 $485.58 2 $3,495.33 $582.55 $3,587.26 $597.87

Group III Income Chart Family Unit Size 7/1/25-6/30/26 Semi-annual 7/1/25-6/30/26 Monthly 7/1/26 Semi-annual 7/1/26 Monthly 1 $3,690.53 $615.08 $3,787.59 $631.26 2 $4,449.18 $741.53 $4,566.19 $761.03

E. ABD Categorically Needy Acronym Definitions Used in the Following Income Charts • ABD – Aged, Blind, Disabled • FPL – Federal Poverty Limit • QDWI – Qualified Disabled Working Individuals • QI – Qualifying Individual • QMB – Qualified Medicare Beneficiary • SLMB – Specified Low-Income Medicare Beneficiary • SSI – Social Security Income The following income charts are for: • ABD 80% FPL, QMB, SLMB, and QI without Social Security income; all QDWI o Effective 1/13/26 o All Localities • ABD 80% FPL, QMB, SLMB, and QI with Social Security income o Effective 3/1/26 o All Localities