PM 06-10-05

(Provider) Uses the income guidelines in the following table to decide if a pregnant woman is eligible for MPE.

Monthly countable income must be equal to or less than 200% of the FPL. The FPL is updated yearly.

revised text2013 Income Standard for MPE
Family Size * Monthly Income
2 $2,585
3 3,255
4 3,925
5 4,595
6 5,265
7 5,935
8 6,605
each additional person 670

*If the pregnant woman has more than one unborn child, increase the family size by the number of additional unborn children and use the corresponding income levels.

Example: A married woman with one child who is expecting twins would have a family size of 5.