COMMONWEALTH OF PENNSYLVANIA Revised 1/24/2013 INCOME COMPARISON OF SSI, NMP, MNO, AND 2013 FEDERAL POVERTY INCOME GUIDELINES (FPIGs)

Persons SSI NMP MNO 100% of 120% of 133% of 135% of FPIG FPIG FPIG FPIG Monthly Monthly Monthly 6 Month Monthly Annual Monthly Annual Monthly Annual Monthly Annual 1 $732.10 $205 $425 $2,550 $958 $11,490 $1,149 $13,788 $1,274 $15,282 $1,293 $15,512 2 $1,099.30 $316 $442 $2,650 $1,293 $15,510 $1,551 $18,612 $1,720 $20,629 $1,745 $20,939 3 $403 $467 $2,800 $1,628 $19,530 $1,953 $23,436 $2,165 $25,975 $2,198 $26,366 4 $497 $567 $3,400 $1,963 $23,550 $2,355 $28,260 $2,611 $31,322 $2,650 $31,793 5 $589 $675 $4,050 $2,298 $27,570 $2,757 $33,084 $3,056 $36,669 $3,102 $37,220 6 $670 $758 $4,550 $2,633 $31,590 $3,159 $37,908 $3,502 $42,015 $3,554 $42,647 7 $753 $850 $5,100 $2,968 $35,610 $3,561 $42,732 $3,947 $47,362 $4.007 $48,074 8 $836 $942 $5,650 $3,303 $39,630 $3,963 $47,556 $4,393 $52,708 $4,459 $53,501 Each Additional $83 $ 92 $ 550 $335 $4,020 $402 $4,824 $446 $5,347 $453 $5,427 Person Includes Group 2 Healthy SLMB  Healthy  QI-1 State Counties Beginnings Beginni Supplemen (age 6 & ngs t older and (age 1 under age through 5) 19) Healthy Horizons

Persons 185% of 200% of FPIG 235% of FPIG 275% of FPIG 300% of FPIG FPIG Monthly Annual Monthly Annual Monthly Annual Monthl Annual Monthly Annual Monthly Annual y 1 $31,59 $1,772 $21,257 $1,915 $22,980 $2,251 $27,002 $2,394 $28,725 $2,634 $2,873 $34,470 8 2 $42,65 $2,392 $28,694 $2,585 $31,020 $3,038 $36,449 $3,232 $38,775 $3,555 $3,878 $46,530 3 3 $53,70 $3,011 $36,131 $3,255 $39,060 $3,825 $45,896 $4,069 $48,825 $4,476 $4,883 $58,590 8 4 $64,76 $3,631 $43,568 $3,925 $47,100 $4,612 $55,343 $4,907 $58,875 $5,397 $5,888 $70,650 3 5 $75,81 $4,251 $51,005 $4,595 $55,140 $5,400 $64,790 $5,744 $68,925 $6,319 $6,893 $82,710 8 6 $86,87 $4,871 $58,442 $5,265 $63,180 $6,187 $74,237 $6,582 $78,975 $7,240 $7,898 $94,770 3 7 $97,92 $5,490 $65,879 $5,935 $71,220 $6,974 $83,684 $7,419 $89,025 $8,161 $8,903 $106,830 8 8 $108,9 $6,110 $73,316 $6,605 $79,260 $7,761 $93,131 $8,257 $99,075 $9,082 $9,908 $118,890 83 COMMONWEALTH OF PENNSYLVANIA Revised 1/24/2013 Each $11,05 Additional $620 $7,437 $670 $8,040 $788 $9,447 $838 $10,050 $922 $1,005 $12,060 Person 5  Extende  Qualified Disabled Working  Family Works  65% Subsidized  60% Subsidized d Individual CHIP CHIP Medical  CHIP (free) Coverag e  Healthy Beginni ngs (pregna nt women and children under 1)  SelectPl an

RESOURCE COMPARISON

No resource limitations for programs with children under 21, except SLMBs and QIs under the Healthy Horizons Program.

NMP PROGRAM MNO PROGRAM SSI PROGRAM TWICE SSI LIMIT Bureau of Policy GA related – one person= $ 250 One person = $2,400 One person = $2,000 One person = $4,000 Division of Health Services GA related – two or more = $1,000 Two person = $3,200 Two person = $3,000 Two person = $6,000 772-7809 Each add. person = $300