Table G: PIL, Granite Advantage, EMA, CM, Pregnant Women MA, FPEC MA, and Expanded CM (MAM)

SR 24-07 Dated 03/24

Previous Policy

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Assistance Group Size

PIL

Granite Advantage Health care Program (Granite Advantage)

< 133%

EMA

< 185%

Children’s Medicaid (CM), Pregnant Women, and FPMA

< 196%

Expanded CM

> 196%, but < 318%

1

$888

$1,670

$2,322

$2,460

$2,460 - $3,991

2

$1033

$2,266

$3,152

$3,339

$3,339 - $5,417

3

$1177

$2,862

$3,981

$4,218

$4,218 - $6,843

4

$1311

$3,458

$4,810

$5,096

$5,096 - $8,268

5

$1444

$4,055

$5,640

$5,975

$5,975 - $9,694

6

$1611

$4,651

$6,469

$6,854

$6,854 - $11,120

7

$1744

$5,247

$7,299

$7,733

$7,733 - $12,546

8

$1944

$5,844

$8,128

$8,611

$8,611 - $13,971

9

$2055

$6,440

$8,958

$9,490

$9,490 - $15,397

10

$2222

$7,036

$9,787

$10,369

$10,369 - $16,823

11

$2411

$7,632

$10,616

$11,248

$11,248 - $18,248

12

$2566

$8,229

$11,446

$12,126

$12,126 - $19,674

For each additional person add:

 

$597

$830

$879

$879 - $1,426

 

See also PART 601, Table J, 5% MAGI Deduction, for more information about the special MAGI-specific income deduction that is applied for those individuals who otherwise meet MAGI MA program requirements but fail the income limit test.

 

References: He-W 841.02(b); He-W 841.03(c); He-W 841.04(a)(2); He-W 841.05; He-W 841.07(a)(2); He-W 841.08(c)(1); He-W 858.04(b); RSA 126-A:5; XXIII(a); 42 CFR 435.119(b)(5); 42 USC 1396b(f)(1)(A)-(C); 42 USC 1396r-6(b)(3)(A)(iii)(III); 42 USC 9902(2)