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Income Eligibility Guidelines Update for Presumptive Eligibility for Pregnant Women

March 26, 2013

Effective April 1, 2013, providers are to use the new Income Eligibility Guidelines as one of the requirements to determine if the recipient is eligible to receive Presumptive Eligibility (PE) for Pregnant Women services during the period of April 1, 2013, through March 31, 2014.

Updated manual replacement pages will be published in a future Medi-Cal Update.

INCOME ELIGIBILITY GUIDELINES
200 PERCENT OF FEDERAL POVERTY LEVEL
Effective April 1, 2013, through March 31, 2014
Number of Persons in the Family Gross Monthly Income Gross Annual Income
2 $2,585 $31,020
3 $3,255 $39,060
4 $3,925 $47,100
5 $4,595 $55,140
6 $5,265 $63,180
7 $5,935 $71,220
8 $6,605 $79,260
For family units of more than 8 members, for each additional member, add: $670 $8,040