Addendum A | Phelps Health

Financial Assistance Annual Income Guidelines
Effective Date: 1-15-2020
Percent of Guidelines		100%	150%	175%	200%	225%
% of Reduction if Less than Guideline	Household	100%	100%	80%	75%	72%
Size of Household	1	$12,760	$19,140	$22,330	$25,520	$28,710
	2	$17,240	$25,860	$30,170	$34,480	$38,790
	3	$21,720	$32,580	$38,010	$43,440	$48,870
	4	$26,200	$39,300	$45,850	$52,400	$58,950
	5	$30,680	$46,020	$53,690	$61,360	$69,030
	6	$35,160	$52,740	$61,530	$70,320	$79,110
	7	$39,640	$59,460	$69,370	$79,280	$89,190
	8	$44,120	$66,180	$77,210	$88,240	$99,270
$4,480 for each additional person