G-1000, Eligibility Budgets Overview

Revision 21-1; Effective March 1, 2021

An eligibility budget is used to determine a person's financial eligibility for Medicaid. Base the type of eligibility budget on:

where the person lives and whether a person is married or not married at the beginning of each month;
whether a person is considered a child; and
whether a person is considered another person's parent.

The setting where a person lives, in part, determines whether an eligibility budget will be:

noninstitutional; or
institutional.

Examples of an institutional setting are a nursing facility or a waiver. Even though the person receiving services though a waiver is living in the community, eligibility factors are based on that person living in an institution.

This chapter will focus on the financial income eligibility budget. However, the person must meet all other requirements to be eligible for Medicaid. The financial resource budget is discussed under Chapter F, Resources.

G-1100, Reserved for Future Use

Revision 24-4; Effective Dec. 1, 2024

G-1200, Definitions

Revision 15-4; Effective December 1, 2015

A child is neither married nor a head of a household and is either:

under age 18; or
under age 22 and a student regularly attending school, college or training that is designed to prepare him/her for a paying job.

See Section D-1210, Definition of a Child, for more information.

A couple is two people who live together and:

present themselves to the community as a married couple, intend to be married and are considered to be married under state law;
are determined to be married for purposes of receiving Social Security benefits; or
are recognized as married under state law.

A dependent relative is a relative who was living in the home of an applicant or recipient before the applicant's or recipient's absence and who is unable to support himself or herself outside of the person's home due to medical, social or other reasons.

A parent is:

a natural or adoptive parent of the child, or
the spouse of the natural or adoptive parent ("stepparent").

The stepparent must be the present spouse of the natural or adoptive parent. A person is not a stepparent if the natural or adoptive parent to whom the stepparent was married has died, or if the parent and stepparent have been divorced or their marriage has been annulled. See Section D-4213, Parent, for more information on the definition of a parent.

G-1300, Income Limits

Revision 12-4; Effective December 1, 2012

The MEPD programs use income limits based on the Supplementary Security Income (SSI) limit up to the 300% of the federal poverty level. For a detailed list of the various income limits for the different programs, see Appendix XXXI, Budget Reference Chart.

G-1310 Community-Based Programs Using SSI Limits

Revision 26-1; Effective March 1, 2026

Use the following income limits for initial certification of programs tested against the Supplemental Security Income (SSI) federal benefit rate (FBR).

Date Range	Individual	Couple
Jan. 1, 2026 to Present	$994	$1,491
Jan. 1, 2025 to Dec. 31, 2025	$967	$1,450
Jan. 1, 2024 to Dec. 31, 2024	$943	$1,415
Jan. 1, 2023 to Dec. 31, 2023	$914	$1,371
Jan. 1, 2022 to Dec. 31, 2022	$841	$1,261
Jan. 1, 2021 to Dec. 31, 2021	$794	$1,191
Jan. 1, 2020 to Dec. 31, 2020	$783	$1,175
Jan. 1, 2019 to Dec. 31, 2019	$771	$1,157
Jan. 1, 2018 to Dec. 31, 2018	$750	$1,125
Jan. 1, 2017 to Dec. 31, 2017	$735	$1,103
Jan. 1, 2016 to Dec. 31, 2016	$733	$1,100
Jan. 1, 2015 to Dec. 31, 2015	$733	$1,100
Jan. 1, 2014 to Dec. 31, 2014	$721	$1,082
Jan. 1, 2013 to Dec. 31, 2013	$710	$1,066
Jan. 1, 2012 to Dec. 31, 2012	$698	$1,048
Jan. 1, 2011 to Dec. 31, 2011	$674	$1,011
Jan. 1, 2010 to Dec. 31, 2010	$674	$1,011

G-1320 Special Income Limits

Revision 26-1; Effective March 1, 2026

Use the following income limits for initial certification of programs tested against the special income limit of 300% of the Supplemental Security Income (SSI) federal benefit rate (FBR).

Date Range	Individual	Couple
Jan. 1, 2026 to Present	$2,982	$5,964
Jan. 1, 2025 to Dec. 31, 2025	$2,901	$5,802
Jan. 1, 2024 to Dec. 31, 2024	$2,829	$5,658
Jan. 1, 2023 to Dec. 31, 2023	$2,742	$5,484
Jan. 1, 2022 to Dec. 31, 2022	$2,523	$5,046
Jan. 1, 2021 to Dec. 31, 2021	$2,382	$4,764
Jan. 1, 2020 to Dec. 31, 2020	$2,349	$4,698
Jan. 1, 2019 to Dec. 31, 2019	$2,313	$4,626
Jan. 1, 2018 to Dec. 31, 2018	$2,250	$4,500
Jan. 1, 2017 to Dec. 31, 2017	$2,205	$4,410
Jan. 1, 2016 to Dec. 31, 2016	$2,199	$4,398
Jan. 1, 2015 to Dec. 31, 2015	$2,199	$4,398
Jan. 1, 2014 to Dec. 31, 2014	$2,163	$4,326
Jan. 1, 2013 to Dec. 31, 2013	$2,130	$4,260
Jan. 1, 2012 to Dec. 31, 2012	$2,094	$4,188
Jan. 1, 2011 to Dec. 31, 2011	$2,022	$4,044
Jan. 1, 2010 to Dec. 31, 2010	$2,022	$4,044