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

2017 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 $2,101 - 3,196 $1,859
2 2,829 - 4,304 2,504
3 3,557 - 5,411 3,148
4 4,286 - 6,519 3,793
5 5,014 - 7,627 4,437
6 5,742 - 8,734 5,081
7 6,470 - 9,842 5,726
8 7,198 - 10,950 6,370
9 7,926 - 12,058 7,014
10 8,654 - 13,166 7,658
Each add'l +1,108 +644

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 $125 per child per calendar quarter