|
|
Wisconsin Department of Health and Family Services |
|
|
Wisconsin Department of Health and Family Services |
| group
size |
100%
FPL |
120%
FPL |
133%
FPL |
135%
FPL |
150%
FPL |
175%
FPL |
185%
FPL |
200%
FPL |
250%
FPL |
| 1 | $797.50 | $957.00 | $1,060.68 | $1,076.63 | $1,196.25 | $1,395.63 | $1,475.38 | $1,595.00 | $1,993.75 |
| 2 | $1,069.17 | $1,283.00 | $1,421.99 | $1,443.38 | $1,603.75 | $1,871.04 | $1,977.96 | $2,138.33 | $2,672.92 |
| 3 | $1,340.83 | $1,609.00 | $1,783.31 | $1,810.13 | $2,011.25 | $2,346.46 | $2,480.54 | $2,681.67 | $3,352.08 |
| 4 | $1,612.50 | $1,935.00 | $2,144.63 | $2,176.88 | $2,418.75 | $2,821.88 | $2,983.13 | $3,225.00 | $4,031.25 |
| 5 | $1,884.17 | $2,261.00 | $2,505.94 | $2,543.63 | $2,826.25 | $3,297.29 | $3,485.71 | $3,768.33 | $4,710.42 |
| 6 | $2,155.83 | $2,587.00 | $2,867.26 | $2,910.38 | $3,233.75 | $3,772.71 | $3,988.29 | $4,311.67 | $5,389.58 |
| 7 | $2,427.50 | $2,913.00 | $3,228.58 | $3,277.13 | $3,641.25 | $4,248.13 | $4,490.88 | $4,855.00 | $6,068.75 |
| 8 | $2,699.17 | $3,239.00 | $3,589.89 | $3,643.88 | $4,048.75 | $4,723.54 | $4,993.46 | $5,398.33 | $6,747.92 |
| 9 | $2,970.83 | $3,565.00 | $3,951.21 | $4,010.63 | $4,456.25 | $5,198.96 | $5,496.04 | $5,941.67 | $7,427.08 |
| 10 | $3,242.50 | $3,891.00 | $4,312.53 | $4,377.38 | $4,863.75 | $5,674.38 | $5,998.63 | $6,485.00 | $8,106.25 |
| 11 | $3,514.17 | $4,217.00 | $4,673.84 | $4,744.13 | $5,271.25 | $6,149.79 | $6,501.21 | $7,028.33 | $8,785.42 |
| 12 | $3,785.83 | $4,543.00 | $5,035.16 | $5,110.88 | $5,678.75 | $6,625.21 | $7,003.79 | $7,571.67 | $9,464.58 |
| 13 | $4,057.50 | $4,869.00 | $5,396.48 | $5,477.63 | $6,086.25 | $7,100.63 | $7,506.38 | $8,115.00 | $10,143.75 |
| 14 | $4,329.17 | $5,195.00 | $5,757.79 | $5,844.38 | $6,493.75 | $7,576.04 | $8,008.96 | $8,658.33 | $10,822.92 |
| 15 | $4,600.83 | $5,521.00 | $6,119.11 | $6,211.13 | $6,901.25 | $8,051.46 | $8,511.54 | $9,201.67 | $11,502.08 |
| 16 | $4,872.50 | $5,847.00 | $6,480.43 | $6,577.88 | $7,308.75 | $8,526.88 | $9,014.13 | $9,745.00 | $12,181.25 |
| 17 | $5,144.17 | $6,173.00 | $6,841.74 | $6,944.63 | $7,716.25 | $9,002.29 | $9,516.71 | $10,288.33 | $12,860.42 |
| 18 | $5,415.83 | $6,499.00 | $7,203.06 | $7,311.38 | $8,123.75 | $9,477.71 | $10,019.29 | $10,831.67 | $13,539.58 |
| 19 | $5,687.50 | $6,825.00 | $7,564.38 | $7,678.13 | $8,531.25 | $9,953.13 | $10,521.88 | $11,375.00 | $14,218.75 |
| 20 | $5,959.17 | $7,151.00 | $7,925.69 | $8,044.88 | $8,938.75 | $10,428.54 | $11,024.46 | $11,918.33 | $14,897.92 |
| 21 | $6,230.83 | $7,477.00 | $8,287.01 | $8,411.63 | $9,346.25 | $10,903.96 | $11,527.04 | $12,461.67 | $15,577.08 |
| 22 | $6,502.50 | $7,803.00 | $8,648.33 | $8,778.38 | $9,753.75 | $11,379.38 | $12,029.63 | $13,005.00 | $16,256.25 |
| 23 | $6,774.17 | $8,129.00 | $9,009.64 | $9,145.13 | $10,161.25 | $11,854.79 | $12,532.21 | $13,548.33 | $16,935.42 |
| 24 | $7,045.83 | $8,455.00 | $9,370.96 | $9,511.88 | $10,568.75 | $12,330.21 | $13,034.79 | $14,091.67 | $17,614.58 |
| each additional
person |
$271.67 | $326.00 | $361.32 | $366.75 | $407.50 | $475.42 | $502.58 | $543.33 | $679.17 |
| • Kids 6 through 18
• QMB |
• SLMB | • Cat Needy Pregnant
Women • PE • kids <6
|
•SLMB+ | • BC premium limit
• MAPP premium limit
|
• ALMB | • Med Needy Pregnant
Women • PE • kids <6 • BC applicant limit |
• QDWI
• BC recipient limit
|
• MAPP |
This page last updated in Release Number: 05-02
Release Date: 05/10/05
Effective Date: 03/01/05
