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Manual Title Virginia Medical Assistance Eligibility Chapter M04 Page Revision Date July 2025 Subchapter Subject M04 MODIFIED ADJUSTED GROSS INCOME (MAGI) Page ending with Appendix 5 Page 1 INDIVIDUALS UNDER AGE 21 INCOME LIMITS

EFFECTIVE 7/1/25 Group I

Household Size Monthly Income Limit Annual Income Limit 1 $315 $3,780 2 481 5,772 3 618 7,416 4 747 8,964 5 880 10,560 6 986 11,832 7 1,114 13,368 8 1,253 15,036 Each additional person add 135 1,620 Group II

Household Size Monthly Income Limit Annual Income Limit 1 $424 $5,088 2 611 7,332 3 765 9,180 4 914 10,968 5 1,079 12,948 6 1,209 14,508 7 1,355 16,260 8 1,509 18,108 Each additional person add 153 1,836 Group III

Household Size Monthly Income Limit Annual Income Limit 1 $560 $6,720 2 752 9,024 3 907 10,884 4 1,062 12,744 5 1,256 15,072 6 1,383 16,596 7 1,534 18,408 8 1,689 20,268 Each additional person add 154 1,848