PM 06-10-05

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

The income standard has been converted to a Modified Adjusted Gross Income (MAGI) equivalent standard. Monthly countable income must be equal to or less than 213% of the FPL (208% + 5% standard disregard). The FPL is updated yearly.

revised text2016 Income Standard for MPE

Family Size * Monthly Income
2 $2,844
3 3,578
4 4,313
5 5,048
6 5,783
7 6,520
8 7,258
each additional person 738

*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.