We break the states that use the fpl as income limits into two groups 1) those that use 100% of the fpl 2) exceptions. The state sets these and can vary from year to year.
See the all kids income standards & cost sharing chart for the limits. Overall, the average subsidy amount was $526/month in 2023 5 and $536/month in 2024.
1 But The Specific Details Vary Significantly From One Area To Another, And Subsidy Amounts Also Depend On The Income Of Each Enrollee Relative To The Prior Year’s Federal Poverty Level.
The cola exclusion is the 2024 income subtracted from the 2023 income.
Copayment Amounts Should Be Updated To The Highest Amount For The Family's Size During This Graduated Phase Out Period.
There is also an asset limit and level of care requirement.
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1) Income Under $1,215 / Month 2) Assets Under $17,500 3) Require A Nursing Home Level Of Care.
Some states, such as illinois, new york, and missouri, offer an alternative option to paying for medical expenses to meet one’s “spend down”.
The Income Limits May Increase Each Year Based On The Federal Poverty Level.
There is also an asset limit and level of care requirement.