48 States and the District of Columbia 2021 Federal Poverty Level (FPL) Guideline Table |
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Family Size | 100% | 135% | 140% | 145% | 150% |
1 | $12,880 | $17,388 | $18,032 | $18,676 | $19,320 |
2 | $17,420 | $23,517 | $24,388 | $25,259 | $26,130 |
3 | $21,960 | $29,646 | $30,744 | $31,842 | $32,940 |
4 | $26,500 | $35,775 | $37,100 | $38,425 | $39,750 |
5 | $31,040 | $41,904 | $43,456 | $45,008 | $46,560 |
6 | $35,580 | $48,033 | $49,812 | $51,591 | $53,370 |
7 | $40,120 | $54,162 | $56,168 | $58,174 | $60,180 |
8 | $44,660 | $60,291 | $62,524 | $64,757 | $66,990 |
9 | $49,200 | $66,420 | $68,880 | $71,340 | $73,800 |
10 | $53,740 | $72,549 | $75,236 | $77,923 | $80,610 |
Additional | $4,540 | $6,129 | $6,356 | $6,583 | $6,810 |
2021 Eligible for QMB/SLMB/QI, SSI or applied and income at or below 135% FPL and resources* < $9,470 (individuals) or < $14,960 (couples) See resource and income level premium benefits in the charts below. |
Alaska 2021 Federal Poverty Level (FPL) Guidelines Table |
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Family Size | 100% | 135% | 140% | 145% | 150% |
1 | $16,090 | $21,722 | $22,526 | $23,331 | $24,135 |
2 | $21,770 | $29,390 | $30,478 | $31,567 | $32,655 |
3 | $27,450 | $37,058 | $38,430 | $39,803 | $41,175 |
4 | $33,130 | $44,726 | $46,382 | $48,039 | $49,695 |
5 | $38,810 | $52,394 | $54,334 | $56,275 | $58,215 |
6 | $44,490 | $60,062 | $62,286 | $64,511 | $66,735 |
7 | $50,170 | $67,730 | $70,238 | $72,747 | $75,255 |
8 | $55,850 | $75,398 | $78,190 | $80,983 | $83,775 |
Additional | $5,680 | $7,668 | $7,952 | $8,236 | $8,520 |
2021 Eligible for QMB/SLMB/QI, SSI or applied and income at or below 135% FPL and resources* < $9,470 (individuals) or < $14,960 (couples) See resource and income level premium benefits in the charts below. |
Hawaii 2021 Federal Poverty Level (FPL) Guidelines Table |
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Family Size | 100% | 135% | 140% | 145% | 150% |
1 | $14,820 | $20,007 | $20,748 | $21,489 | $22,230 |
2 | $20,040 | $27,054 | $28,056 | $29,058 | $30,060 |
3 | $25,260 | $34,101 | $35,364 | $36,627 | $37,890 |
4 | $30,480 | $41,148 | $42,672 | $44,196 | $45,720 |
5 | $35,700 | $48,195 | $49,980 | $51,765 | $53,550 |
6 | $40,920 | $55,242 | $57,288 | $59,334 | $61,380 |
7 | $46,140 | $62,289 | $64,596 | $66,903 | $69,210 |
8 | $51,360 | $69,336 | $71,904 | $74,472 | $77,040 |
Additional | $5,220 | $7,047 | $7,308 | $7,569 | $7,830 |
2021 Eligible for QMB/SLMB/QI, SSI or applied and income at or below 135% FPL and resources* < $9,470 (individuals) or < $14,960 (couples) See resource and income level premium benefits in the charts below. |
Individual’s Countable Resources* | Individual’s Countable Income | Amount of the Premium Subsidy |
---|---|---|
$7,970 or less | At or below 135% FPL | 100% |
$7,970.01 to $13,290 | At or below 135% FPL | 100% but less help with co-pays or deductibles |
$13,290 or less |
More than 135% of FPL, but at or below 140% |
75% |
$13,290 or less |
More than 140% of FPL, but at or below 145% |
50% |
$13,290 or less |
More than 145% of FPL, but less than 150% |
25% |
$13,290.01 or more | Any amount | Not eligible for premium subsidy |
Couple’s Countable Resources* |
Couple’s Countable Income | Amount of the Premium Subsidy |
---|---|---|
$11,960 or less | At or below 135% FPL | 100% |
$11,960.01 to $26,520 | At or below 135% FPL | 100% but less help with co-pays or deductibles |
$26,520 or less |
More than 135% of FPL, but at or below 140% |
75% |
$26,520 or less |
More than 140% of FPL, but at or below 145% |
50% |
$26,520 or less |
More than 145% of FPL, but less than 150% |
25% |
$26,520.01 or more | Any amount | Not eligible for premium subsidy |