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Appendix 2

The following table represents discounts which may be available to patients whose annual income, as taken from HHS Notice issued on the date below:

2025 Poverty Guidelines for the 48 Contiguous States and the District of Columbia
Date: 1-1-2026
Percent of Federal Poverty Guidelines100%150%175%200%225% 
% of Reduction if Less than GuidelineHousehold100%100%80%75%75% 
Size of Household1 $15,960 $23,940 $27,930 $31,920 $35,910 
 2 $21,640 $32,460 $37,870 $43,280 $48,690 
 3 $27,320 $40,980 $47,810 $54,640 $61,470 
 4 $33,000 $49,500$57,750 $66,000 $74,250 
 5 $38,680 $58,020 $67,690 $77,360 $87,030 
 6 $44,360 $66,540 $77,630 $88,720 $99,810 
 7 $50,040 $75,060 $87,570 $100,080 $112,590 
 8 $55,720 $83,580 $97,510 $111,440 $125,370 
For families/households with more than 8 persons, add $5,500 for each additional person.     
financial assistance, annual income guidelines, income guidelines, health services help, Appendix 2