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Addendum A

Financial Assistance Annual Income Guidelines
Effective Date: 1-17-2024
Percent of Federal Poverty Guidelines 100% 150% 175% 200% 225%  
% of Reduction if Less than Guideline Household 100% 100% 80% 75% 75%  
Size of Household 1  $15,060  $22,590  $26,355  $30,120  $33,885  
  2  $20,440  $30,660  $35,770  $40,880  $45,990  
  3  $25,820  $38,730  $45,185  $51,640  $58,095  
  4  $31,200  $46,800 $54,600  $62,400  $70,200  
  5  $36,580  $54,870  $64,015  $73,160  $82,305  
  6  $41,960  $62,940  $73,430  $83,920  $94,410  
  7  $47,340  $71,010  $82,845  $94,680  $106,515  
  8  $52,720  $79,080  $92,260  $105,440  $118,620  

For families/households with more than 8 persons, add $5,380 for each additional person.

         
financial assistance, annual income guidelines, income guidelines, health services help