|
Sliding Fee Schedule
Effective January 23, 2008
Annual
Family Income
|
Family Size
|
Medicaid/
Nominal Rate
|
25% Pay
|
50% Pay
|
75% Pay
|
Full Pay
|
|
1 |
13,000 |
13,001 - 17,333 |
17,334 - 21,667 |
21,668 - 26,000 |
26,001 |
|
2 |
17,500 |
17,501 - 23,333 |
23,334 - 29,167 |
29,168 - 35,000 |
35,001 |
|
3 |
22,000 |
22,001 - 29,333 |
29,334 - 36,667 |
36,668 - 44,000 |
44,001 |
|
4 |
26,500 |
26,501 - 35,333 |
35,334 - 44,167 |
44,168 - 53,000 |
53,001 |
|
5 |
31,000 |
31,001 - 41,333 |
41,334 - 51,667 |
51,668 - 62,000 |
62,001 |
|
6 |
35,500 |
35,501 - 47,333 |
47,334 - 59,167 |
59,168
- 71,000 |
71,001 |
|
7 |
40,000 |
40,001 - 53,333 |
53,334 - 66,667 |
66,668 - 80,000 |
80,001 |
|
8 |
44,500 |
44,501 - 59,333 |
59,334 - 74,167 |
74,168 - 89,000 |
89,001 |
|
9 |
49,000 |
49,001 - 65,333 |
65,334 - 81,667 |
81,668 - 98,000 |
98,001 |
|
10 |
53,500 |
53,501 - 71,333 |
71,334 - 89,167 |
89,168 - 107,000 |
107,001 |
|
|
For each additional person,
add $4,500
|
Revised January 23, 2008 based on the
Poverty Income Guidelines per
Federal Register
January 23, 2008 / Notices |
|
Monthly
Family Income
|
Family Size
|
Medicaid/
Nominal Rate
|
25% Pay
|
50% Pay
|
75% Pay
|
Full Pay
|
|
1
|
1,083 |
1,084 - 1,441 |
1,442 - 1,809 |
1,810 - 2,167 |
2,168 |
|
2
|
1,458 |
1,459 - 1,940 |
1,941 - 2,435 |
2,436 - 2,917 |
2,918 |
|
3
|
1,833 |
1,834 - 2,438 |
2,439 - 3,062 |
3,063 - 3,667 |
3,668 |
|
4
|
2,208 |
2,209 - 2,937 |
2,938 - 3,688 |
3,689 - 4,417 |
4,418 |
|
5
|
2,583 |
2,584 - 3,436 |
3,437 - 4,314 |
4,315 - 5,167 |
5,168 |
|
6
|
2,958 |
2,959 - 3,935 |
3,936 - 4,940 |
4,941 - 5,917 |
5,918 |
|
7
|
3,333 |
3,334 - 4,433 |
4,434 - 5,567 |
5,568 - 6,667 |
6,668 |
|
8
|
3,708 |
3,709 - 4,932 |
4,933 - 6,193 |
6,194 - 7,417 |
7,418 |
|
9
|
4,083 |
4,084 - 5,431 |
5,432 - 6,819 |
6,820 - 8,167 |
8,168 |
|
10
|
4,458 |
4,459 - 5,930 |
5,931 - 7,445 |
7,446 - 8,917 |
8,918 |
|
|
For each additional person, add
$375
|
Revised January 23, 2008 based on the Poverty
Income Guidelines per Federal Register
January 23, 2008 / Notices |
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