The Federal Poverty Level (FPL) is a measure of income published every year by the U.S. Department of Health and Human Services (HHS) and is calculated based on household size. A household's FPL is used to determine eligibility for certain programs and benefits, including eligibility for premium tax credits and cost sharing reductions through Pennie, as well as eligibility for Medicaid (Medical Assistance or MA) and the Children’s Health Insurance Program (CHIP).
Pennie will use the 2022 federal poverty level guidelines, as listed below, to calculate eligibility for financial savings for individuals enrolling in 2023 coverage through Pennie. This is because eligibility for financial savings through Pennie is based on projected income for the entire year. The FPL percentages displayed below indicate income thresholds for each household size at different tiers of eligibility for financial savings.
Eligibility for financial savings for 2023 coverage through Pennie:
2023 FPL Percentages | ||||
Household / Family Size | 100% | 150% | 250% | 400% |
Individual | $14,580 | $21,870 | $36,450 | $58,320 |
2-person | $19,720 | $29,580 | $49,300 | $78,880 |
3-person | $24,860 | $37,290 | $62,150 | $99,440 |
4-person | $30,000 | $45,000 | $75,000 | $120,000 |
6-person | $40,280 | $60,420 | $100,700 | $161,120 |
8-person | $50,560 | $77,100 | $126,400 | $202,240 |
Pennie will use the 2023 federal poverty level guidelines, as listed below, to assess a customer's potential eligibility for Medicaid (MA) / CHIP. This update will occur at the end of March every year, because Medicaid/CHIP eligibility is based on a household’s actual monthly income. The FPL percentages displayed below indicate income thresholds for adult eligibility for MA and low-cost CHIP for children under age 19 for each household size.
2023 Medical Assistance (MA) and CHIP Income Thresholds:
2023 FPL Percentages | ||
Household / Family Size | 138% (Adult MA) | 314% (Low-cost CHIP) |
Individual | $20,120 | $45,782 |
2-person | $27,214 | $61,921 |
3-person | $34,307 | $78,061 |
4-person | $41,400 | $94,200 |
6-person | $48,493 | $126,480 |
8-person | $69,773 | $158,759 |