48 States and the District of Columbia 2019 Federal Poverty Level (FPL) Guideline Table |
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Family Size | 100% | 135% | 140% | 145% | 150% |
1 | $12,490.00 | $16,861.50 | $17,486.00 | $18,110.50 | $18,735.00 |
2 | $16,910.00 | $22,828.50 | $23,674.00 | $24,519.50 | $25,365.00 |
3 | $21,330.00 | $28,795.50 | $29,862.00 | $30,928.50 | $31,995.00 |
4 | $25,750.00 | $34,762.50 | $36,050.00 | $37,337.50 | $38,625.00 |
5 | $30,170.00 | $40,729.50 | $42,238.00 | $43,746.50 | $45,255.00 |
6 | $34,590.00 | $46,696.50 | $48,426.00 | $50,155.50 | $51,885.00 |
7 | $39,010.00 | $52,663.50 | $54,614.00 | $56,564.50 | $58,515.00 |
8 | $43,430.00 | $58,630.50 | $60,802.00 | $62,973.50 | $65,145.00 |
9 | $47,850.00 | $64,597.50 | $66,990.00 | $69,382.50 | $71,775.00 |
10 | $52,270.00 | $70,564.50 | $73,178.00 | $75,791.50 | $78,405.00 |
Additional | $4,420.00 | $5,967.00 | $6,188.00 | $6,409.00 | $6,630.00 |
2019 Eligible for QMB/SLMB/QI, SSI or applied and income at or below 135% FPL and resources < $9,230 (individuals) or < $14,600 (couples)* 2020 Eligible for QMB/SLMB/QI, SSI or applied and income at or below 135% FPL and resources < $9,360 (individuals) or < $14,800 (couples)* See resource and income level premium benefits in the charts below. |
Alaska 2019 Federal Poverty Level (FPL) Guidelines Table |
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Family Size | 100% | 135% | 140% | 145% | 150% |
1 | $15,600.00 | $21,060.00 | $21,840.00 | $22,620.00 | $23,400.00 |
2 | $21,130.00 | $28,525.50 | $29,582.00 | $30,638.50 | $31,695.00 |
3 | $26,660.00 | $35,991.00 | $37,324.00 | $38,657.00 | $39,990.00 |
4 | $32,190.00 | $43,456.50 | $45,066.00 | $46,675.50 | $48,285.00 |
5 | $37,720.00 | $50,922.00 | $52,808.00 | $54,694.00 | $56,580.00 |
6 | $43,250.00 | $58,387.50 | $60,550.00 | $62,712.50 | $64,875.00 |
7 | $48,780.00 | $65,853.00 | $68,292.00 | $70,731.00 | $73,170.00 |
8 | $54,310.00 | $73,318.50 | $76,034.00 | $78,749.50 | $81,465.00 |
Additional | $5,530.00 | $7,465.50 | $7,742.00 | $8,018.50 | $8,295.00 |
2019 Eligible for QMB/SLMB/QI, SSI or applied and income at or below 135% FPL and resources < $9,230 (individuals) or < $14,600 (couples)* 2020 Eligible for QMB/SLMB/QI, SSI or applied and income at or below 135% FPL and resources < $9,360 (individuals) or < $14,800 (couples)* See resource and income level premium benefits in the charts below. |
Hawaii 2019 Federal Poverty Level (FPL) Guidelines Table |
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Family Size | 100% | 135% | 140% | 145% | 150% |
1 | $14,380.00 | $19,413.00 | $20,132.00 | $20,851.00 | $21,570.00 |
2 | $19,460.00 | $26,271.00 | $27,244.00 | $28,217.00 | $29,190.00 |
3 | $24,540.00 | $33,129.00 | $34,356.00 | $35,583.00 | $36,810.00 |
4 | $29,620.00 | $39,987.00 | $41,468.00 | $42,949.00 | $44,430.00 |
5 | $34,700.00 | $46,845.00 | $48,580.00 | $50,315.00 | $52,050.00 |
6 | $39,780.00 | $53,703.00 | $55,692.00 | $57,681.00 | $59,670.00 |
7 | $44,860.00 | $60,561.00 | $62,804.00 | $65,047.00 | $67,290.00 |
8 | $49,940.00 | $67,419.00 | $69,916.00 | $72,413.00 | $74,910.00 |
Additional | $5,080.00 | $6,858.00 | $7,112.00 | $7,366.00 | $7,620.00 |
2019 Eligible for QMB/SLMB/QI, SSI or applied and income at or below 135% FPL and resources < $9,230 (individuals) or < $14,600 (couples)* 2020 Eligible for QMB/SLMB/QI, SSI or applied and income at or below 135% FPL and resources < $9,360 (individuals) or < $14,800 (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 |
---|---|---|
$7,860 or less | At or below 135% FPL | 100% |
$7,860.01 to $13,110 | At or below 135% FPL | 100% but less help with co-pays or deductibles |
$13,110 or less |
More than 135% of FPL, but at or below 140% |
75% |
$13,110 or less |
More than 140% of FPL, but at or below 145% |
50% |
$13,110 or less |
More than 145% of FPL, but less than 150% |
25% |
$13,110.01 or more | Any amount | Not eligible for premium subsidy |
Individual’s Countable Resources* | Individual’s Countable Income | Amount of the Premium Subsidy |
---|---|---|
$7,730 or less | At or below 135% FPL | 100% |
$7,730.01 to $12,890 | At or below 135% FPL | 100% but less help with co-pays or deductibles |
$12,890 or less |
More than 135% of FPL, but at or below 140% |
75% |
$12,890 or less |
More than 140% of FPL, but at or below 145% |
50% |
$12,890 or less |
More than 145% of FPL, but less than 150% |
25% |
$12,890.01 or more | Any amount | Not eligible for premium subsidy |
Couple’s Countable Resources* |
Couple’s Countable Income | Amount of the Premium Subsidy |
---|---|---|
$11,800 or less | At or below 135% FPL | 100% |
$11,800.01 to $26,160 | At or below 135% FPL | 100% but less help with co-pays or deductibles |
$26,160 or less |
More than 135% of FPL, but at or below 140% |
75% |
$26,160 or less |
More than 140% of FPL, but at or below 145% |
50% |
$26,160 or less |
More than 145% of FPL, but less than 150% |
25% |
$26,160.01 or more | Any amount | Not eligible for premium subsidy |
Couple’s Countable Resources* |
Couple’s Countable Income | Amount of the Premium Subsidy |
---|---|---|
$11,600 or less | At or below 135% FPL | 100% |
$11,600.01 to $25,720 | At or below 135% FPL | 100% but less help with co-pays or deductibles |
$25,720 or less |
More than 135% of FPL, but at or below 140% |
75% |
$25,720 or less |
More than 140% of FPL, but at or below 145% |
50% |
$25,720 or less |
More than 145% of FPL, but less than 150% |
25% |
$25,720.01 or more | Any amount | Not eligible for premium subsidy |