All Kids and Extended Medical Standards, Premiums and Co-pays

2019 Income Standards

Revised text

# in

unit

Premium Level 2

MAGI - Over 209% to 318% FPL

(includes 5% disregard)

Medical Extension

185% FPL

(No limit for first 6 months; limit for Adults after first 6 months only)

1 $2,176 - 3,310 $1,926
2 2,946 - 4,481 2,607
3 3,716 - 5,652 3,288
4 4,486 - 6,824 3,970
5 5,256 - 7,995 4,651
6 6,025 - 9,166 5,333
7 6,795 - 10,338 6,014
8 7,565 - 11,509 6,695
9 8,335 - 12,680 7,376
10 9,105 - 13,851 8,057
Each add'l +1,171 +681

All Kids & FamilyCare Premiums and Physician Co-Pays

Assist

children & adults

Share

children

Premium Level 1

children

Premium Level 2

children

Co-Pay for Physician Office Visit

$0 for children;

$3.90 for adults

$3.90 $5 for children $10 for children
Monthly Premium None None

$15 - 1 person

$25 - 2 persons

$5 each add'l

$40 per child
Max Monthly Premium N/A N/A $40 for 5 or more persons $80 for 2 or more children
Max Co-Payments per Year N/A $100 per family $100 per family $500 per child