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Manual Title Virginia Medical Assistance Eligibility Chapter M04 Page Revision Date January 2025 Subchapter Subject M04 MODIFIED ADJUSTED GROSS INCOME (MAGI) Page ending with Appendix 2 Page 1

*A pregnant woman’s household is at least two individuals when evaluated in the Pregnant Women covered group. PREGNANT WOMEN 143% FPL INCOME LIMITS ALL LOCALITIES EFFECTIVE 1/15/25 Household Size 143% FPL Yearly Amount 143% FPL Monthly Amount 148% FPL (143% FPL + 5% FPL Disregard) *2 $30,245 $2,521 $2,609 3 38,110 3,176 3,287 4 45,975 3,832 3,966 5 53,840 4,487 4,644 6 61,705 5,143 5,322 7 69,570 5,798 6,001 8 77,435 6,453 6,679 Each additional, add 7,865 656 679