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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 2

CHILD UNDER AGE 19 143% FPL INCOME LIMITS ALL LOCALITIES EFFECTIVE 1/15/25 # of Persons in House- hold 109% FPL (for Determining Aid Category) 143% FPL 148% FPL (143% FPL + 5% FPL Disregard) Monthly Limit Annual Limit Monthly Limit Monthly Limit 1 $1,422 $22,380 $1,865 $1,931 2 1,922 30,245 2,521 2,609 3 2,421 38,110 3,176 3,287 4 2,921 45,975 3,832 3,966 5 3,420 53,840 4,487 4,644 6 3,920 61,705 5,143 5,322 7 4,420 69,570 5,798 6,001 8 4,919 77,435 6,453 6,679 Each add’l, add 500 7,865 656 679