Federal Poverty Level (used to calculate Medicaid and ACA eligibility)

Overview

The Federal Poverty Level (FPL) is a measure of income issued every year by the Department of Health and Human Services (HHS). Federal poverty levels are used to determine eligibility for Affordable Care Act health insurance subsidies, Medicaid and CHIP coverage, and other federal low-income programs.

The 2018 federal poverty level (FPL) income numbers below are used to calculate eligibility for Medicaid and the Children’s Health Insurance Program (CHIP). 2017 numbers are slightly lower, and are used to calculate savings on Marketplace insurance plans for 2018.

$12,140 for individuals
$16,460 for a family of 2
$20,780 for a family of 3
$25,100 for a family of 4
$29,420 for a family of 5
$33,740 for a family of 6
$38,060 for a family of 7
$42,380 for a family of 8

Federal Poverty Level amounts are higher in Alaska and Hawaii. See all HHS poverty guidelines for 2018.

How federal poverty levels are used to determine eligibility for reduced-cost health coverage

Income between 100% and 400% FPL: If your income is in this range, in all states you qualify for premium tax credits that lower your monthly premium for a Marketplace health insurance plan.
Income below 138% FPL: If your income is below 138% FPL and your state has expanded Medicaid coverage, you qualify for Medicaid based only on your income.
Income below 100% FPL: If your income falls below 100% FPL and your state hasn’t expanded Medicaid coverage, you won’t qualify for either income-based Medicaid or savings on a Marketplace health insurance plan. You may still qualify for Medicaid under your state’s current rules.

“Income” above refers to “modified adjusted gross income” (MAGI). For most people, it is the same or very similar to “adjusted gross income” (AGI).

Source: Healthcare.gov

Federal Poverty Level (used to calculate Medicaid and ACA eligibility)

Overview

How federal poverty levels are used to determine eligibility for reduced-cost health coverage

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