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 text2017 Income Standard for MPE

Family Size * Monthly Income
2 $2,883
3 3,625
4 4,367
5 5,108
6 5,850
7 6,592
8 7,334
each additional person 742

revised text *To determine the family size, include the total number of babies the pregnant woman is expecting to deliver.

Revised text Example: A family includes a husband, a wife who is pregnant with twins and one child.  The family size is 5.