The 2021 Federal Poverty Guidelines (for 2022 Cost assistance and 2021 Medicaid/CHIP)
These guidelines are the key to all cost assistance under the Affordable Care Act. Specifically, these guidelines are used for:
- Medicaid/CHIP between late Jan 2021 – Jan 2022 after the poverty level guidelines are published.
- 2022 marketplace cost assistance on all marketplace health plans held in 2022 and purchased during open enrollment for 2022 (which runs from November 1, 2021, to December 15, 2021, and which uses the 2021 levels).
- For special enrollment in 2021.
- For ACA taxes for the 2021 calendar year filed in 2022.
NOTE: Our federal poverty guideline list has the 100% poverty level, 138% Medicaid expansion threshold, the 250% CSR subsidy threshold, and the 400% premium tax credit thresholds so you can at a glance see what assistance you qualify for. Please note that for Medicaid Expansion if you make under 138% you qualify, for CSR it is between 100% – 250%, and for tax credits it is between 100% and 400%. See details on subsidies under the ACA.
TIP: For mobile and smaller screen sizes, drag the table below to scroll and see the different poverty levels.
|2021 POVERTY GUIDELINES FOR THE 48 CONTIGUOUS STATES AND THE DISTRICT OF COLUMBIA|
|Persons in Family/Household||100% FPL: Minimum to Qualify for ACA Assistance||138% FPL: Medicaid Cap (in States that Expanded)||250% FPL: CSR Subsidies Cap||400% FPL: Premium Tax Credit Cap|
|For families/households with more than 8 persons, add $4,540 for each additional person.|
FACT: The Federal Register notice for the 2021 Poverty Guidelines was published on February 1st, 2021.
How to calculate a percentage of the Federal Poverty Level: Medicaid uses the 138% of the Federal Poverty level to determine assistance. The math works like this. Take the published guideline dollar amount, multiply by 1.38, and then round up. So for example $12,880 x 1.38 = $17,777.40. We round up, and therefore $17,775 is 138% of the Federal Poverty Level threshold for 2021 Medicaid and CHIP. The methodology is the same for all FPL percentages. We have made the calculations for you above, but it still helps to know the methodology.
Medicaid and CHIP: You can sign up for Medicaid and CHIP 365 days a year. You may qualify for free or low-cost care for Medicaid based on income and family size if you make 138% of the poverty level or, for example, $17,775 individual or $36.570 for a family of four in 2021. Specifics may differ by state.
Healthcare Cost Assistance: You may qualify for marketplace cost assistance based on income and family size each year if you make between 100% – 400% of the federal poverty level. For 2022 assistance you’ll use the 2021 poverty levels. Thus, if you make between $12,880 – $51,520 as an individual or $26,500 – $106,000 as a family in 2022, you’ll qualify for cost assistance. Please note marketplace cost assistance can be taken in advance based on projected income, but is adjusted for actual income at tax time.
- notice 2021-01969. Federalregister.gov.