Addendum A | Phelps Health

Financial Assistance Annual Income Guidelines
Effective Date: 1-13-2021
Percent of Guidelines		100%	150%	175%	200%	225%
% of Reduction if Less than Guideline	Household	100%	100%	80%	75%	72%
Size of Household	1	$12,880	$19,320	$22,540	$25,760	$28,980
	2	$17,420	$26,130	$30,485	$34,840	$39,195
	3	$21,960	$32,940	$38,430	$43,920	$49,410
	4	$26,500	$39,750	$46,375	$53,000	$59,625
	5	$31,040	$46,560	$54,320	$62,080	$69,840
	6	$35,580	$53,370	$62,265	$71,160	$80,055
	7	$40,120	$60,180	$70,210	$80,240	$90,270
	8	$44,600	$66,900	$78,050	$89,200	$100,350
$4,540 for each additional person