2022 Income Eligibility Guidelines for Family PACT Program

April 22, 2022

Effective for dates of service on or after April 1, 2022, Family Planning Access, Care and Treatment (Family PACT) Program providers are to use the following income eligibility guidelines when determining client eligibility for Family PACT services. Providers should disregard all previous Family PACT income eligibility guidelines charts.

Federal Income Guidelines
200 Percent of Poverty by Family Size
Effective April 1, 2022

Number of Persons In family/household

Monthly Income
(In dollars)

Annual Income
(In dollars)

1 2,265 27,180
2 3,052 36,620
3 3,838 46,060
4 4,625 55,500
5 5,412 64,940
6 6,198 74,380
7 6,985 83,820
8 7,772 93,260
For each additional person, add: 787 9,440

These changes will be reflected in the provider manual in an upcoming Medi-Cal Update.