How to Apply for Services

Income Charts

 Food Stamps

Effective: October 1, 2015

Household
Size

Gross Monthly Income
for All Other
Households

Gross Monthly Income
Used to Determine
Household Composition
for Elderly/Disabled
Households
 

Maximum
Monthly
Allotment

1

1276  1619

194

2

1726

  2191

357

3

2177

 2763

511

4

2628

 3335

649

5

3078

 3907

771

6

3529

 4479

925

7

3980

 5051

1022

8

4430

 5623

1169

4881 6195

1315

10 

5332  6767

 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, 2015

Household
Size

Gross Monthly
Income at
application

Gross Monthly Income
while receiving
Child Care Assistance*

2

2245

2806

3

2773

3466

4

3301

4127

5

3829

4787

6

4358

5447

7

4457

5571

8

4556

5695

9

4655

5818

10

4754

5942

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

 

Lifeline - Utah Telephone Assistance Program (UTAP)

Effective: January 1, 2016

Household
Size

Gross
Income 

1

1336.50

2

1802.25

3

2268.00

4

2733.75

Add $468 for each additional person

 

Medicaid Help for Families and Children

Effective: March 1, 2016

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 1377 1317 382  1832 1485 1980 941
2 544 1856 1776 468  2470 2003 2670  1269
3 678 2326 2235 583  3108 2520 3460  1596
4 797 2815 2694 682  3747 3038 4050  1924
5 912 3295 3153 777  4385 3555 4740  2252
6 1012 3774 3611 857  5023 4073 5430  2580
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

990  2475

990

1188

 1337

2

1335  3338 1335

1602

 1803

3 1680  4200      
4 2025  5063      
5 2370  5925      
6 2715  6788      
7 3061  7653      
8 3408  8519      
9 3755 9386      
10 4101 10253