Wisconsin Department of Health and Family Services |
|
Number of Fetuses |
|||||||
|
MA Category |
FFU Size |
0 |
1 |
2 |
3 |
4 |
5 |
MAU/ MAR |
AFDC |
|
** |
** |
** |
** |
** |
** |
MAOU/ MAOR |
AFDC-Related MA (cat needy) area 1 |
1 |
$311 |
$550.00 |
$647.00 |
$772.00 |
$886.00 |
$958.00 |
2 |
$275.00 |
$431.33 |
$579.00 |
$708.80 |
$798.33 |
$888.86 | ||
3 |
$215.67 |
$386.00 |
$531.60 |
$638.67 |
$740.71 |
$824.25 | ||
MAOU/ MAOR |
AFDC-Related MA Area 2 (cat needy) |
1 |
$301.00 |
$533.00 |
$626.00 |
$749.00 |
$861.00 |
$929.00 |
2 |
$266.50 |
$417.33 |
$561.75 |
$688.80 |
$774.17 |
$863.14 | ||
3 |
$208.67 |
$374.50 |
$516.60 |
$619.33 |
$719.29 |
$801.00 | ||
NAOR |
AFDC-Related MA (med needy) |
1 |
$591.67 |
$591.67 |
$689.33 |
$822.67 |
$944.00 |
$1,021.33 |
2 |
$295.84 |
$459.55 |
$617.00 |
$755.20 |
$851.11 |
$947.43 | ||
3 |
$229.78 |
$411.34 |
$566.40 |
$680.89 |
$789.52 |
$879.00 | ||
MHSN |
Healthy Start children age 6-19 |
1 |
$797.50 |
*** |
*** |
*** |
*** |
*** |
2 |
$534.58 |
*** |
*** |
*** |
*** |
*** | ||
3 |
$446.94 |
*** |
*** |
*** |
*** |
*** | ||
MHSC/ MHSP |
Healthy Start Pregnant Women & Children < 6 (cat needy) |
1 |
$1,060.68 |
$1,421.99 |
$1,783.31 |
$2,144.63 |
$2,505.94 |
$2,867.26 |
2 |
$711.00 |
$1,188.87 |
$1,608.47 |
$2,004.75 |
$2,389.38 |
$2,767.35 | ||
3 |
$594.44 |
$1,072.31 |
$1,503.57 |
$1,911.51 |
$2,306.13 |
$2,692.42 | ||
NHSC/ NHSP |
Healthy Start Pregnant Women & Children < 6 (med Needy) |
1 |
$1,475.38 |
$1,977.96 |
$2,480.54 |
$2,983.13 |
$3,485.71 |
$3,988.29 |
2 |
$988.98 |
$1,653.69 |
$2,237.34 |
$2,788.57 |
$3,323.58 |
$3,849.32 | ||
3 |
$826.85 |
$1,491.56 |
$2,091.43 |
$2,658.86 |
$3,207.77 |
$3,745.09 |
** FFU is not used in determining eligibility for AFDC-Medicaid .
*** Pregnant women are not eligible for this category. Determine pregnant women under the age of 19 for Health Start for Women instead.
This page last updated in Release Number: 05-02
Release Date: 05-10-05
Effective Date: 03-01-05