MANUAL TRANSMITTAL
Arkansas Department of Human Services
Division of County Operations
Policy Directive Issuance Number: MS 99-7
Medical Services Policy Manual Issuance Date: April 1, 1999
From: Ruth Whitney, Director Expiration Date: Until Superseded
Subj: New Federal Poverty Levels
The attached chart provides the 1999 Federal Poverty Level income guidelines to be effective April 1, 1999, for the following categories:
MS 2047.2 #7
Qualified Medicare Beneficiary (QMB) –
Qualified Disabled and Working Individuals (QDWI) –
Specified Low Income Medicare Beneficiaries (SMB) – MS 2051.3 #7
Transitional Medicaid (TM) – MS 2062.3
Qualifying Individuals – 1 (QI-1) – MS 2073.3 #7
Qualifying Individuals – 2 (QI-2) – MS 2074.3 #7
ARKids First – MS 2330 #8
SOBRA Pregnant Women, Infants and Children (SOBRA) –
Family Planning Demonstration Waiver – MS 5914 #1
These income guidelines will supersede the 1998 figures currently in policy at the above policy references. The 1998 guidelines will be deleted at a later date.
Instructions for processing SSA COLA changes for QMB, SMB, QI-1 and QI-2 cases are being issued to county offices under separate cover.
Inquiries to: Jack Tiner, 501-682-8259
Ann Dawson, 501-682-8254
Boyce Lovett, 501-682-1562
1999 FEDERAL POVERTY LEVELS
Monthly Levels
(April 1, 1999 through March 31, 2000)
FAMILY MEDICAID CATEGORIES
Family Size |
SOBRA Children 6 & Over Born After 9/30/82 & 100% |
SOBRA Pregnant Women, Infants and Children up to 133% |
Transitional Medicaid
185% |
ARKids First
200% |
1 |
686.67 |
913.27 |
1,270.34 |
1,373.34 |
2 |
921.67 |
1,225.82 |
1,705.09 |
1,843.34 |
3 |
1,156.67 |
1,538.37 |
2,139.84 |
2,313.34 |
4 |
1,391.67 |
1,850.92 |
2,574.59 |
2,783.34 |
5 |
1,626.67 |
2,163.47 |
3,009.34 |
3,253.34 |
6 |
1,861.67 |
2,476.02 |
3,444.09 |
3,723.34 |
7 |
2,096.67 |
2,788.57 |
3,878.84 |
4,193.34 |
8 |
2,331.67 |
3,101.12 |
4,313.59 |
4,663.34 |
9 |
2,566.67 |
3,413.67 |
4,748.34 |
5,133.34 |
10 |
2,801.67 |
3,726.22 |
5,183.09 |
5,603.34 |
| For each additional member add: | 235.00 |
312.55 |
434.75 |
470.00 |
AABD MEDICAID CATEGORIES
QMB Equal To or Below |
SMB Between 100% & 120% |
QI-1 At least 120% but Less Than 135% |
QI-2 At least 135% but Less Than 175% |
QDWI Equal To or Below |
|
| Individual | 686.67 |
824.00 |
927.00 |
1,201.67 |
1,373.34 |
| Couple | 921.67 |
1,106.00 |
1,244.25 |
1612.92 |
1,843.34 |