2025 Ryan White Part B Financial Eligibility Guidelines
Effective April 1, 2025
Gross income must be equal to or less than 500% of the Federal Poverty Level (FPL)
| Size of Family | Annual FPL (100%) | Medicaid FPL (138%) | Annual Gross (500%) | Monthly Gross (500%) | Bi-monthly Gross (500%) | Bi-weekly Gross (500%) | Weekly Gross (500%) |
| 1 | $15,650.00 | $21,597.00 | $78,250.00 | $6,520.83 | $3,260.42 | $3,009.62 | $1,504.81 |
| 2 | $21,150.00 | $29,187.00 | $105,750.00 | $8,812.50 | $4,406.25 | $4,067.31 | $2,033.65 |
| 3 | $26,650.00 | $36,777.00 | $133,250.00 | $11,104.17 | $5,552.09 | $5,125.00 | $2,562.50 |
| 4 | $32,150.00 | $44,367.00 | $160,750.00 | $13,395.83 | $6,697.92 | $6,182.69 | $3,091.35 |
| 5 | $37,650.00 | $51,957.00 | $188,250.00 | $15,687.50 | $7,843.75 | $7,240.38 | $3,620.19 |
| 6 | $43,150.00 | $59,547.00 | $215,750.00 | $17,979.17 | $8,989.59 | $8,298.08 | $4,149.04 |
| 7 | $48,650.00 | $67,137.00 | $243,250.00 | $20,270.83 | $10,135.42 | $9,355.77 | $4,677.88 |
| 8 | $54,150.00 | $74,727.00 | $270,750.00 | $22,562.50 | $11,281.25 | $10,413.46 | $5,206.73 |
For families with more than eight (8) people, add $5,500 to the annual 100% FPL calculation for each additional person. Source: U.S. Department of Health & Human Services.
Determining Client’s Income for Program Eligibility
1. Identify length of pay period on income verification document (i.e. pay studs, award letter, etc.).
| Pay Period Length | Description | Example |
| Monthly | 1 pay per calendar month | Receives SSDI benefit on the 1st of every month. |
| Bi-Monthly | 2 pays per calendar month | Receives paycheck the 1st & 15th of every month. |
| Bi-Weekly | 1 pay every 14 days / 2 calendar weeks | Receives a paycheck every other Friday. |
| Weekly | 1 pay every 7 days / 1 calendar week | Receives a paycheck every Friday. |
2. Calculate gross annual income.
| Monthly | Multiply check amount by 12. |
| Bi-Monthly | Add 2 check amounts together, divide total by 2 to get the average, multiply average by 24. |
| Bi-Weekly | Add 2 check amounts together, divide total by 2 to get the average, multiply average by 26. |
| Weekly | Add 4 check amounts together, divide total by 4 to get the average, multiply average by 52. |
3. Compare the calculated annual gross income with the program eligibility guidelines shown in chart above for appropriate family size.
4. Refer clients with an FPL at or below 138% to Medicaid to complete enrollment application.