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

5713

*Once you are approved for child care, the income limit increases.

Medicaid Help for Families and Children

Effective March1, 2014

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

1 438 1352 1294 382  1800 1459 1945
2 544 1823 1744 468  2426 1967 2622
3 678 2293 2194 583  3051 2474 3299
4 797 2763 2644 682  3677 2982 3975
5 912 3233 3094 777  4303 3489 4652
6 1012 3704 3544 857  4929 3997 5329
7 1072 4174 3994 897  5555 4504 6005
8 1132 4644 4444 938  6181 5012 6682
9 1196 5115 4894 982  6807 5519 7359
10 1257 5585 5344 1023  7433 6027 8035

 

 

Household
Size

Income Limit
for:

 

Aged & Disabled
(AM & DM)

 

Medically Needy

Aged, Blind,
Disabled (ABD)

Primary Care
Network (PCN)

 

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

973  2432

973

1167

 1313

2

1311  3278 1311

1573

 1770

3 1650  4123      
4 1988  4969      
5 2326  5815      
6 2665  6661      
7 3003  7507      
8 3341  8353      
9 3680 9198      
10 4018 10044