WAG 25-03-02 (4) Medical

Medical Extension 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)

1 $ 2,095
2 2,823
3 3,550
4 4,278
5 5,006
6 5,733
7 6,461
8 7,189
9 7,917
10 8,645
Each add'l +728

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