Presumptive Eligibility Pregnant Woman (PE-PW)
*Limited Benefit
Income Limit
209% of FPL
- Family Size 1 – Income: $2,779.70
- Family Size 2 – Income: $3,768.97
- Family Size 3 – Income: $4,758.23
- Family Size 4 – Income: $5,747.50
- Family Size 5 – Income: $6,736.77
Add $989.27 for each additional member
Earned Income Deductions
214% of FPL
Additional 5% Income Disregard if needed
- Family Size 1 – Income: $2,846.20
- Family Size 2 – Income: $3,859.13
- Family Size 3 – Income: $4,872.07
- Family Size 4 – Income: $5,885.00
- Family Size 5 – Income: $6,897.93
Add $1012.93 for each additional member
Resource Limit
- No Resource Limit
Excluded From Resources
- N/A
Counted Toward Resource Limit
- N/A
Other
- Pregnant
- No other active Health Care coverage
- Self-Attested Information only
- Number of expected babies are included in the household size
- Start date will be date of determination
- End date will be date of final determination of a full category