WAG 25-03-02 (4) Medical

Medical Extension, AK Share & Premiums Income Standards and Co-pays

2022 Income Standards

Revised manual text

# In

Unit

Medical Extension

185% FPL

(No limit for first 6 months;

limit for Adults after first 6 months only)

  All Kids

  Share

157% FPL

   All Kids

Premium Level 1

  209% FPL

  All Kids

Premium Level 2

  318% FPL

1 $ 2,095 $1,666 - 1,778 $1,779 - 2,367 $2,368 - 3,601
2 2,823 2,244 - 2,396 2,397 - 3,189 3,190 - 4,852
3 3,550 2,822 - 3,013 3,014 - 4,011 4,012 - 6,103
4 4,278 3,400 - 3,631 3,632 - 4,833 4,834 - 7,354
5 5,006 3,979 - 4,248 4,249 - 5,655 5,656 - 8,605
6 5,733 4,557 - 4,866 4,867 - 6,477 6,478 - 9,855
7 6,461 5,135 - 5,483 5,484 - 7,299 7,300 - 11,106
8 7,189 5,713 - 6,101 6,102 - 8,121 8,122 - 12,357
9 7,917 6,291 - 6,719 6,720 - 8,943 8,944 - 13,608
10 8,645 6,869 - 7,337 7,338 - 9,765 9,766 - 14,859
Each add'l +728 +618 +822 +1,251

All Kids & FamilyCare Premiums and Physician Co-Pays

Assist

children & adults

Co-Pay for Physician Office Visit

$ 0 for children

$ 0 for Medicaid adults

Monthly Premium None
Max Monthly Premium N/A
Max Co-Payments per Year N/A