How to Apply for Services

Income Charts

Food Stamps (Updated October 1, 2008)

Household
Size

Gross Monthly Income
for Elderly/Disabled
Households

Gross Monthly Income
for All Other
Households

Maximum
Monthly
Allotment

1

1430

1127

176

2

1925

1517

323

3

2420

1907

463

4

2915

2297

588

5

3410

2687

698

6

3905

3077

838

7

4400

3467

926

8

4859

3857

1058

For each additional member add: 

495

390

132

Family Employment Program/Refugee Cash Assistance

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

General Assistance/Working Towards Employment

Household
Size

Gross Income
 

Maximum Cash
Assistance Amount

 

1

608

261

 

2

843

362

Employment Support Child Care (Updated October1, 2008)

Household Size

Gross Monthly
Income at application

Gross Monthly Income
while receiving
Child Care Assistance*

2

$2018

$2522

3

$2493

$3116

4

$2967

$3709

5

$3442

$4303

6

$3917

$4896

7

$4006

$5007

8

$4095

$5119

9

$4184

$5230

10

$4273

$5341

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

Medicaid Help for Families and Children (Updated March 1, 2008)

Household
Size
 
 
 
 
 
 
 
GrossIncome
Limit for:
 
 Family
Medicaid
(FM-O)
 
 
 
 
 
 
Income Limit for:
 
Medically Needy
Child (CM) 
Regular Family
Medicaid (FM)
 Pregnant Women (PG)
Refugees (RM)
 
Net Income Limit
for Family Medicaid
(FM-O)
Income Limit for:

Newborn Plus
(NB+)
Childrens Health
Insurance Program
(CHIP PLAN A)
Technology
Dependent Children
  
 
100% of Poverty
Income Limitfor:

PreNatal (PN)
Newborn (NB)
Baby Your Baby
 
 
 
 
 
133% of Poverty
Income Limit for:

Transitional
benefits for
Family Medicaid
(FM-O)
 
 
 
 
 
185% of Poverty
Income Limit for:

Childrens Health
Insurance Program
(CHIP PLAN B)
Utah’s Premium
Partnership for
Health Insurance
(UPP Adults)
 
 
150% of Poverty
Income Limit for:

Childrens Health
Insurance Program
(CHIP PLAN C)
Utah’s Premium
Partnership for
Health Insurance
(UPP Children)
 
 
200% of Poverty
1 623 382 867 1153 1604 1300 1734
2 866 468 1167 1552 2159 1750 2334
3 1079 583 1467 1951 2714 2200 2934
4 1262 682 1767 2350 3269 2650 3534
5 1437 777 2067 2749 3824 3100 4134
6 1584 857 2367 3148 4379 3550 4734
7 1658 897 2667 3547 4934 4000 5334
8 1735 938 2967 3946 5489 4450 5934
9 1817 982 3267 4345 6044 4900 6534
10 1893 1023 3567 4744 6599 5350 7134

Medical Help for Adults and People with Disabilities (Updated March 1, 2008)

Household
Size
Income Limit
for:
 
Refugees (RM)
Income Limit
for:
 
Aged, Blind, or Disabled
(AM, BM, DM)
Brain Injury Mental
Retardation and
Related Concerns
(DDMR)
Aging Home and
Community Based
Program (AW)
 
100% of Poverty
Income Limit
for:
 
Primary Care
Network (PCN)
 
 
 
 
 
 
 
150% 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:
 
MEDICARE
COST-SHARING
QI-1
 
 
 
 
 
 
135% of Poverty

1

382

867

1277

2167

867

1040

1170

2

468

1167

1750

2917

1167

1400

1575

3 583 1467 2200 3667
4 682 1767 2650 4417
5 777 2067 3100 5167
6 857 2367 3550 5917
7 897 2667 4000 6667
8 938 2967 4450 7417
9 982 6237 4900 8167
10 1023 3567 5350 8917

 

 





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