Appendix B: Income and Resource Limits for Specified Low-Income MA Beneficiaries (SLMB)

 

Income Limits - 120% of the Federal Poverty Guidelines**
Effective 1/26/17

Family Size*

Monthly Limits

Annual Limit

1
2
3
4
5
6
7
8

Each additional person

$1,206.00

$1,624.00

$2,042.00

$2,460.00

$2,878.00

$3,296.00

$3,714.00

$4,132.00

 

$418.00

 

$14,472.00

$19,488.00

$24,504.00

$29,520.00

$34,536.00

$39,552.00

$44,568.00

$49,584.00

 

$5,016.00

* Count each individual, including unborn children, who is included in the Healthy Horizons family.

**The income limit for SLMB's is more than 100% but less than 120%.

See Chapter 388, Appendix B, Buy-In Desk Guide for additional information.

 

Income Limits - 120% of the Federal Poverty Guidelines**
Effective 1/25/16

Family Size*

Monthly Limits

Annual Limit

1
2
3
4
5
6
7
8

Each additional person

$1,188.00

$1,602.00

$2,016.00

$2,430.00

$2,844.00

$3,258.00

$3,673.00

$4,089.00

 

$416.00

 

$14,256.00

$19,224.00

$24,192.00

$29,160.00

$34,128.00

$39,096.00

$44,076.00

$49,068.00

 

$4,992.00

* Count each individual, including unborn children, who is included in the Healthy Horizons family.

**The income limit for SLMB's is more than 100% but less that 120%.

 

 

Resource Limits
Effective 1/1/2017

                              Resource Limits

                            Effective 1/1/2016

Family Size*

SLMB Eligible

1 person    $7,390


2 or more    $11,090

$7,280

 

  $10,930

Family Size*

SLMB and MNO Eligible

1 person     $2,400


2 or more   $3,200

$2,400


$3,200

Each additional individual $300

* Use the two-person limit when the Healthy Horizons family includes more than one individual, including unborn children.

 

Updated March 1, 2017,  Replacing January 4, 2017