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Presumptive Income Tool

Income Calculation Tool - Effective April 1, 2017

 

Download and Print the Income Calculation Tool

Montana Presumptive Eligibility Income Calculation Tool
Effective April 1, 2017
Program ======►

HMK PLUS
Ages <19

HMK
Ages <19

Parent/Caretaker
Relative Medicaid

Individuals between the ages of 19-64 Pregnant Woman
 

Former Foster Care Children
Ages 18 up to 26

Breast and Cervical Cancer

Considerations ==►

    

  • Other insurance IS allowed

 

  • Other insurance is NOT allowed
  • Other insurance IS allowed
  • Household must have child under 19 related to adults
  • Other insurance IS allowed
  • Other insurance IS allowed
  • Other insurance IS allowed
  • There is no income limit for this program
  • Other insurance IS allowed
  • There is no income limit for this program
Who to Count for Household Size ==► Include all those on the application connected by Marriage or Parentage who live in the household, along with the unborn children.  Include parents (natural, adoptive, step); dependent children living in the household (birth, adoptive, step under the age of 19); and unborn children of these persons.  A significant other who is the parent of a child/children in the household (other than unborns) should be counted.  DO NOT INCLUDE other adult relatives who file their own tax return.  Include all those on the application connected by Marriage or Parentage who live in the household, along with the unborn children.  Include parents (natural, adoptive, step); dependent children living in the household (birth, adoptive, step under the age of 19); and unborn children of these persons.  A significant other who is the parent of a child/children in the household (other than unborns) should be counted.  DO NOT INCLUDE other adult relatives who file their own tax return.  Include all those on the application connected by Marriage or Parentage who live in the household, along with the unborn children.  Include parents (natural, adoptive, step); dependent children living in the household (birth, adoptive, step under the age of 19); and unborn children of these persons.  A significant other who is the parent of a child/children in the household (other than unborns) should be counted.  DO NOT INCLUDE other adult relatives who file their own tax return.  Count only the individual. Include the woman, the unborn child/children, the father of the unborn (if married and present in the household) and any other children (of the unborns married parent) under age 19 who live in the household. Count only the individual. Income and household size do not need to be evaluated for PE since they are reviewed during the Breast and Cervical Cancer screening process. 

Household Size
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Maximum
Monthly
Adjusted Gross Income
Maximum
Monthly
Adjusted Gross Income
Maximum
Monthly
Adjusted Gross Income
Maximum
Monthly
Adjusted Gross Income
Maximum
Monthly
Adjusted Gross Income
Maximum
Monthly
Adjusted Gross Income
Maximum
Monthly
Adjusted Gross Income

1

$1509

$2754

$253

$1404

$1657

$2639

$2639

2

$2032

$3709

$341

$1890

$2231

$3553


$3553

3

$2555

$4663

$428

$2376

$2806

$4468


$4468

4

$3072

$5619

$517

$2863

$3380

$5381


$5381

5

$3602

$6573

$605

$3350

$3953

$6296


$6296

6

$4124

$7527

$692

$3836

$4528

$7210


$7210

7

$4647

$8482

$780

$4322

$5102

$8125


$8125

8

$5170

$9440

$867

$4809

$5676

$9039


$9039

9

$5693

$10391

$956

$5295

$6251

$9954


$9954

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