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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 6 Page 1

PLAN FIRST 200% FPL INCOME LIMITS ALL LOCALITIES EFFECTIVE 1/15/25 Household Size 200% FPL Yearly Amount 200% FPL Monthly Amount 205% FPL (200% FPL + 5% FPL Disregard) Monthly Amount 1 $31,300 $2,609 $2,674 2 42,300 3,525 3,614 3 53,300 4,442 4,553 4 64,300 5,359 5,493 5 75,300 6,275 6,432 6 86,300 7,192 7,372 7 97,300 8,109 8,312 8 108,300 9,025 9,251 Each additional, add 11,000 917 940