Income Levels 510-03-85-40
(Revised 4/1/2024 ML 3790)
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(N.D.A.C. Sections 75-02-02.1-40, 75-02-02.1-22(7), 75-02-02.1-24.2(8), and 75-02-02.1-24(5))
Following are the Income Levels for the various categories under ACA Medicaid Categorically Needy:
- Parents and Caretakers of Deprived Children and their Spouses who are NOT eligible for Medicare, SSI or over age 65 – (ACA Equivalent to 1931 Levels).
The family size is increased for each unborn when determining the appropriate family size.
Household Size Monthly Income Level Yearly Income Level 1 $517 $6,204 2 694 8,328 3 871 10,452 4 1048 12,576 5 1226 14,712 6 1403 16,836 7 1580 18,960 8 1757 21,084 9 1934 23,208 10 2111 25,332 Plus - 1 178 2,136 Effective January 1, 2014
- Parents and Caretaker Relatives who ARE Medicare beneficiaries, SSI recipients or over age 65. (Parent and Caretaker Relative fixed dollar level listed in #1 above PLUS the 5% Federal Poverty Level disregard.)
The family size is increased for each unborn when determining the appropriate family size.
Household Size Monthly Income Level Annual Income 1 $566 $6,792 2 760 9,120 3 955 11,460 4 1,149 13,788 5 1,344 16,128 6 1,539 18,468 7 1,733 20,796 8 1,927 23,124 9 2,122 25,464 10 2,316 27,792 Plus - 1 195 2,339 Effective April 1, 2015
- Children ages 6 through 18 and Individuals eligible for the Adult Expansion Group - 133% + the 5% disregard or 138%.
The family size is increased for each unborn when determining the appropriate family size.
Household Size Monthly Income Level Annual Income Level 1 $1,732 $20,783 2 2,351 28,208 3 2,970 35,632 4 3,588 43,056 5 4,207 50,481 6 4,826 57,905 7 5,445 65,330 8 6,063 72,754 9 6,682 80,178 10 7,301 87,603 Plus - 1 $619 7,425 Effective April 1, 2024
- Children ages 0 through 6 - 147% + the 5% disregard or 152%.
The family size is increased for each unborn when determining the appropriate family size.
Household Size Monthly Income Level Annual Income Level 1 $1,908 22,892 2 2,590 31,069 3 3,271 39,247 4 3,952 47,424 5 4,634 55,602 6 5,315 63,780 7 5,997 71,957 8 6,678 80,135 9 7,360 88,312 10 8,041 96,490 +1 $682 $8,178 Effective April 1, 2024
- ACA Adults age 19 and 20 and Medically Needy Pregnant Women, Children and Parent/Caretaker relative - 90% of Poverty Level. See Non-ACA Medicaid Policy income considerations, income deductions and income disregards.
The family size is increased for each unborn when determining the appropriate family size.
Household Size Monthly Income Level Yearly Income Level 1 $1,130 13,554 2 1,533 18,396 3 1,937 23,238 4 2,340 28,080 5 2,744 32,922 6 3,147 37,764 7 3,551 42,448 8 3,954 47,448 9 4,358 52,290 10 4,761 57,132 +1 $404 $4,842 Effective April 1, 2024
- Pregnant Women - 170% + 5% Disregard or 175%
The family size is increased for each unborn when determining the appropriate family size.
|
Household Size |
Monthly Income Level |
Yearly Income Level |
| 1 |
$2,197 |
$26,355 |
| 2 | 2,981 | 35,770 |
| 3 | 3,766 | 45,185 |
| 4 | 4,550 | 54,600 |
| 5 | 5,335 | 64,015 |
| 6 | 6,120 | 73,430 |
| 7 | 6,904 | 82,845 |
| 8 | 7,689 | 92,260 |
| 9 | 8,473 | 101,675 |
| 10 | 9,258 | 111,090 |
| +1 | $785 | $9,415 |
| Effective April 1, 2024 | ||
- Optional Targeted Low-Income Children (CHIP) - 200% + 5% Disregard or 205%.
The family size is increased for each unborn when determining the appropriate family size.
|
Household Size |
Monthly Income Level |
Yearly Income Level |
| 1 |
$2,573 |
$30,873 |
| 2 |
3,492 |
41,902 |
| 3 | 4,411 | 52,931 |
| 4 | 5,330 | 63,960 |
| 5 | 6,250 | 74,989 |
| 6 | 7,169 | 86,018 |
| 7 | 8,088 | 97,047 |
| 8 | 9,007 | 108,076 |
| 9 | 9,926 | 119,105 |
| 10 | 10,845 | 130,134 |
| +1 | $920 | $11,029 |
| Effective April 1, 2024 | ||
- ACA Maintenance of Effort – Medicaid – Children ages 6 through 18.
The family size is increased for each unborn when determining the appropriate family size.
Household
Size
111% FPL
Monthly
111% FPL
Annual
133% FPL
Monthly
133% FPL
Annual
1 $1,394
$16,717 $1,670 $20,030 2 1,891 22,689 2,266 27,186 3 2,389 28,661 2,862 34,341 4 2,886 34,632 3,458 41,496 5 3,384 40,604 4,005 48,652 6 3,882 46,576 4,651 55,807 7 4,379 52,548 5,247 62,963 8 4,877 58,520 5,844 70,118 9 5,375 64,491 6,440 77,273 10 5,872 70,463 7,036 84,429 +1 $498 $5,972 $597 $7,156 Effective April 1, 2024
