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.