How to Apply for Services

Income Charts

 Food Stamps

Effective: October 1, 2014

Household
Size

Gross Monthly Income
for All Other
Households

Gross Monthly Income
for Elderly/Disabled
Households
 

Maximum
Monthly
Allotment

1

1265  1605

194

2

1705

  2163 

357

3

2144

 2722

511

4

2584

 3280

649

5

3024

 3838

771

6

3464

 4396

925

7

3904

 4955

1022

8

4344

 5513

1169

4784  6072

1315

10 

5224  6631

 1461 

 

Family Employment Program/Refugee Cash Assistance

Effective: May 1, 2012

Household
Size

Gross
Income 

Maximum Cash
Assistance Amount

1

608

288

2

843

399

3

1050

498

4

1230

583

5

1400

663

6

1542

731

7

1615

765

8

1690

801

 9

1770 

839

 10

1844 

 874 

 

 General Assistance

Effective May 1, 2012

Household
Size

Gross
Income 

Maximum Cash
Assistance Amount

 

1

608

287

 

2

843

398

 

 Child Care

Effective: October 1, 2014

Household
Size

Gross Monthly
Income at
application

Gross Monthly Income
while receiving
Child Care Assistance*

2

2159

2699

3

2667

3334

4

3175

3969

5

3683

4604

6

4191

5239

7

4286

5358

8

4382

5477

9

4477

5596

10

4572

5715

*Once you are approved for Child Care, the income limit increases.

 

Lifeline - Utah Telephone Assistance Program (UTAP)

Effective: January 1, 2015

Household
Size

Gross
Income 

1

1324.13

2

1792.13

3

2260.13

4

2728.13

Add $468 for each additional person

 

Medicaid Help for Families and Children

Effective: March 1, 2015

Household
Size
 

Gross
Income
Limit for:
 


MAGI

 Family
Medicaid
(PCR -
Parent,
C
aretaker,
Relative)

Income
 
Limit for: 

MAGI 


Pregnant
Woman,
 Child 0-5






139% of
Poverty

Income
 
Limit for: 

 MAGI

Child 6-18








133% of 
Poverty

Income
Limit for:

 Non-MAGI 


Medically
Needy Family
- Related

Refugee   

 Income
Limit for:

Non-MAGI

PCR
(Parent,
Caretaker,
Relative)

12-Month
Transitional


185% of
Poverty

Income 
Limit f
or:

MAGI 


 Children's Health
Insurance Program
 (CHIP Plan B)   






150% of
Poverty 

Income
Limit for:

MAGI
 


Children's Health
Insurance Program
(CHIP Plan C)

Utah's Premium

Partnership for
 Health Insurance
(UPP)   

200% of
Poverty

 Income
Limit for:

 

Primary Care
Network (PCN)

 


95% of
Poverty

1 438 1364 1305 382  1815 1472 1962 932
2 544 1846 1766 468  2456 1992 2655  1262
3 678 2328 21227 583  3098 2512 3349  1591
4 797 2809 2688 682  3739 3032 4042  1920
5 912 3291 3149 777  4380 3552 4735  2250
6 1012 3773 3610 857  5022 4072 5429  2579
7 1072 4255 4071 897  5663 4592 6122  2908
8 1132 4737 4532 938  6304 5112 6815  3238
9 1196 5219 4994 982  6946 5632 7509  3567
10 1257 5701 5455 1023  7587 6152 8202  3896

 

 

Household
Size

Income Limit
for:

 

Aged & Disabled
(AM & DM)

 

Medically Needy

Aged, Blind,
Disabled (ABD)

 

100% of Poverty

Income Limit
for:

 

MEDICAID WORK

INCENTIVE

(MWI)

 

 


 

250% of Poverty

Income Limit
for:

 

MEDICARE
COST-
SHARING

QMB

 

 



100% of Poverty

Income Limit
for:

 

MEDICARE
COST- SHARING

SLMB

 

 



120% of Poverty

 Income Limit
for:

QI-1






135% of Poverty

1

981  2453

981

1177

 1325

2

1328  3319 1328

1593

 1793

3 1675  4186      
4 2021  5053      
5 2368  5919      
6 2715  6786      
7 3061  7653      
8 3408  8519      
9 3755 9386      
10 4101 10253