M-7000, Premiums

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Revision 21-2; Effective June 1, 2021

A person may have to pay a monthly premium as a condition of eligibility. The premium amounts are based on a sliding scale, dependent upon the person's income. The MBI monthly premium amount is determined based on the person's unearned and earned income.

M-7100, Post Eligibility — Premium Budgets

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Revision 26-2; Effective June 1, 2026

Premium Budgeting Steps

There are three steps to calculate the premium amount.

Note: While unearned income is excluded in the income eligibility budget, it is used in the calculation of the premium amount.

Step 1: Calculate Unearned Income Premium

The unearned income premium amount is based on unearned income after allowable exemptions and exclusions.

Note: Support and maintenance does not apply to the MBI program.

Calculate the unearned income premium amount by subtracting the SSI federal benefit rate amount for one person from their countable unearned income.

Step 2: Calculate Earned Income Premium

Calculate the earned income premium amount by adding:

  • gross earned income minus mandatory payroll deductions; and
  • any countable earned self-employment income.

This calculation results in the net earnings. If the net earnings are equal to or less than 150% of the federal poverty level (FPL), the monthly premium is $0. If the net earnings exceed 150% of the FPL, the person must pay a monthly premium based on the earned income amount. Use the following table to compare the net earnings amount to the FPL ranges and determine the earned income premium amount.

The 2026 FPL ranges for the earned income premium amounts are listed in the chart below. Income limits are subject to change annually.

2026 FPL RangeEarned Income Premium Amount
Earnings at or below 150% FPL - less than or equal to $1,995$0
Earnings above 150% FPL up to and including 185% FPL -  greater than $1,995 up to and including $2,461$20
Earnings above 185% FPL up to and including 200% FPL - greater than $2,461 up to and including $2,660$25
Earnings above 200% FPL up to and including 250% FPL - greater than $2,660 up to and including $3,325$30
Earnings above 250% FPL - greater than $3,325$40

Step 3: Calculate Total Monthly Premium

Add the unearned income premium amount to the earned income premium amount to get the total monthly MBI premium amount.

The total monthly premium may not exceed $500. If the unearned income premium amount plus the earned income premium amount is greater than or equal to $500, then the total monthly premium is $500.

Examples

Below are three examples for calculating the MBI premium.

Example 1

A person has $1,025 in unearned monthly income. After applying all deductions, the remaining earned income is $1,250.

  1. Subtract the SSI federal benefit rate amount for one person from the person's countable unearned income.

$1,025 unearned income - $994 SSI federal benefit rate = $31 unearned income premium amount

  1. Compare the net earned income to the chart showing the FPL ranges to find the earned income premium amount.

$1,250 net monthly earnings = $0 earned income premium amount

  1. Add the unearned income premium amount to the earned income premium amount to get the total monthly MBI premium amount.

$31 unearned income premium amount + $0 earned income premium amount = $31 total monthly premium

Example 2

A person has $1,025 in monthly unearned income, and $2,015 in monthly earned income after applying all deductions.

  1. Subtract the SSI federal benefit rate amount from the person's countable unearned income.

    $1,025 unearned income - $994 SSI federal benefit rate = $31 unearned income premium amount
     
  2. Compare the net earned income to the chart showing the FPL ranges to find the earned income premium amount.

    $2,015 net monthly earnings = $20 earned income premium amount
     
  3. Add the unearned income premium amount to the earned income premium amount to get the total monthly MBI premium amount.

    $31 unearned income premium amount + $20 earned income premium amount = $51 total monthly premium

Example 3

A person has $1,551 in monthly unearned income and $2,029in monthly earned income after applying all deductions.

  1. Subtract the SSI federal benefit rate amount from the person's countable unearned income.

$1,551 unearned income - $994 federal benefit rate = $557 unearned income premium amount

  1. Compare the net earned income to the chart showing the FPL ranges to find the earned income premium amount.

$2,029 net monthly earnings = $20 earned income premium amount

  1. Add the unearned income premium amount to the earned income premium amount to get the total monthly MBI premium amount.

$557 unearned income premium amount + $20 earned income premium amount = $577* total monthly premium

* The total of the unearned income premium amount plus the earned income premium amount is $577. However, the total monthly premium cannot exceed $500.

Related Policy

Budget Reference Chart, Appendix XXXI