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

Income Limits - 120% of the Federal Poverty Guidelines**
Effective 1/11/19

Family Size*

Monthly Limits

Annual Limit

1
2
3
4
5
6
7
8

Each additional person

$1,249.00

$1,691.00

$2,133.00

$2,575.00

$3,017.00

$3,459.00

$3,901.00

$4,343.00

$442.00

$14,988.00

$20,292.00

$25,596.00

$30,900.00

$36,204.00

$41,508.00

$46,812.00

$52,116.00

$5,304.00

* 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 1/13/18

Family Size*

Monthly Limits

Annual Limit

1
2
3
4
5
6
7
8

Each additional person

$1,214.00

$1,646.00

$2,078.00

$2,510.00

$2,942.00

$3,374.00

$3,806.00

$4,238.00

$432.00

$14,568.00

$19,752.00

$24,936.00

$30,120.00

$35,304.00

$40,488.00

$45,672.00

$50,856.00

$5,184.00

* 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 1/26/17

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 that 120%.

Resource Limits Effective 1/1/2019	Resource Limits Effective 1/1/2018
Family Size*	SLMB Eligible
1 person $7,730 2 or more $11,600	$7,560 $11,340
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 February 01, 2019, Replacing November 29, 2018