Medical Assistance Eligibility Handbook
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Appendix A Standard of Need

Group 1

Number of Persons
in Budget Group

Each
Additional
Person

 

1

2

3

4

5

6


$121

$313

$481

$614

$749

$885

$1,001

Counties: Bucks, Chester, Lancaster, Montgomery, Pike

Group 2

Number of Persons
in Budget Group

Each
Additional
Person

 

1

2

3

4

5

6


$121

$298

$461

$587

$724

$859

$976

Counties: Adams, Allegheny, Berks, Blair, Bradford, Butler, Centre, Columbia, Crawford, Cumberland, Dauphin, Delaware, Erie, Lackawanna, Lebanon, Lehigh, Luzerne, Lycoming, Monroe, Montour, Northampton, Philadelphia, Sullivan, Susquehanna, Union, Warren, Wayne, Westmoreland, Wyoming, York

Group 3

Number of Person
 in Budget Group

Each
Additional
Person

 

1

2

3

4

5

6


$121

$284

$444

$573

$698

$829

$943

Counties: Beaver, Cameron, Carbon, Clinton, Elk, Franklin, Indiana, Lawrence, McKean, Mercer, Mifflin, Perry, Potter, Snyder, Tioga, Venango, Washington

Group 4

Number of Persons in Budget Group

Each Additional Person

 

1

2

3

4

5

6


$121

$253

$406

$532

$662

$791

$894

Counties: Armstrong, Bedford, Cambria, Clarion, Clearfield, Fayette, Forest, Fulton, Greene, Huntingdon, Jefferson, Juniata, Northumberland, Schuylkill, Somerset

NOTE:  If the applicant/recipient group includes a pregnant woman and the pregnancy is medically confirmed, the CAO must count the unborn child as a member of the group when setting the income limit. If multiple births are confirmed, count each unborn child.

Updated February 14, 2012, Replacing June 23, 2008