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Income Table

Income bands effective July 1, 2008 - June 30, 2009

Use your family's gross monthly income (before taxes and other deductions) and the number of people in your family to determine your income band on the income table below. If you fall within one of these income bands, you may be eligible for Basic Health. If your income is above these bands, you may not be eligible for Basic Health at this time.

The number of persons in your family means you, your spouse, children, and/or any legal dependents, including those who are disabled or full-time students under age 23, even if they're not living at home. Be sure to count all family members, even those you don't want to enroll, because family size is used to determine your monthly premium.

Family Size	Income Band
	A	B	C	D	E	F	G	H
1	$0.00 - 563.33	$563.34 - 866.66	$866.67 - 1,083.33	$1,083.34 - 1,213.33	$1,213.34 - 1,343.33	$1,343.34 - 1,473.33	$1,473.34 - 1,603.33	$1,603.34 - 1,733.41
2	$0.00 - 758.33	$758.34 - 1,166.66	$1,166.67 - 1,458.33	$1,458.34 - 1,633.33	$1,633.34 - 1,808.33	$1,808.34 - 1,983.33	$1,983.34 - 2,158.33	$2,158.34 - 2,333.44
3	$0.00 - 953.33	$953.34 - 1,466.66	$1,466.67 - 1,833.33	$1,833.34 - 2,053.33	$2,053.34 - 2,273.33	$2,273.34 - 2,493.33	$2,493.34 - 2,713.33	$2,713.34 - 2,933.47
4	$0.00 - 1,148.33	$1,148.34 - 1,766.66	$1,766.67 - 2,208.33	$2,208.34 - 2,473.33	$2,473.34 - 2,738.33	$2,738.34 - 3,003.33	$3,003.34 - 3,268.33	$3,268.34 - 3,533.50
5	$0.00 - 1,343.33	$1,343.34 - 2,066.66	$2,066.67 - 2,583.33	$2,583.34 - 2,893.33	$2,893.34 - 3,203.33	$3,203.34 - 3,513.33	$3,513.34 - 3,823.33	$3,823.34 - 4,133.53
6	$0.00 - 1,538.33	$1,538.34 - 2,366.66	$2,366.67 - 2,958.33	$2,958.34 - 3,313.33	$3,313.34 - 3,668.33	$3,668.34 - 4,023.33	$4,023.34 - 4,378.33	$4,378.34 - 4,733.56
7	$0.00 - 1,733.33	$1,733.34 - 2,666.66	$2,666.67 - 3,333.33	$3,333.34 - 3,733.33	$3,733.34 - 4,133.33	$4,133.34 - 4,533.33	$4,533.34 - 4,933.33	$4,933.34 - 5,333.59
8	$0.00 - 1,928.33	$1,928.34 - 2,966.66	$2,966.67 - 3,708.33	$3,708.34 - 4,153.33	$4,153.34 - 4,598.33	$4,598.34 - 5,043.33	$5,043.34 - 5,488.33	$5,488.34 - 5,933.62
9	$0.00 - 2,123.33	$2,123.34 - 3,266.66	$3,266.67 - 4,083.33	$4,083.34 - 4,573.33	$4,573.34 - 5,063.33	$5,063.34 - 5,553.33	$5,553.34 - 6,043.33	$6,043.34 - 6,533.65
10	$0.00 - 2,318.33	$2,318.34 - 3,566.66	$3,566.67 - 4,458.33	$4,458.34 - 4,993.33	$4,993.34 - 5,528.33	$5,528.34 - 6,063.33	$6,063.34 - 6,598.33	$6,598.34 - 7,133.68
11	$0.00 - 2,513.33	$2,513.34 - 3,866.66	$3,866.67 - 4,833.33	$4,833.34 - 5,413.33	$5,413.34 - 5,993.33	$5,993.34 - 6,573.33	$6,573.34 - 7,153.33	$7,153.34 - 7,733.71
12	$0.00 - 2,708.33	$2,708.34 - 4,166.66	$4,166.67 - 5,208.33	$5,208.34 - 5,833.33	$5,833.34 - 6,458.33	$6,458.34 - 7,083.33	$7,083.34 - 7,708.33	$7,708.34 - 8,333.74
13	$0.00 - 2,903.33	$2,903.34 - 4,466.66	$4,466.67 - 5,583.33	$5,583.34 - 6,253.33	$6,253.34 - 6,923.33	$6,923.34 - 7,593.33	$7,593.34 - 8,263.33	$8,263.34 - 8,933.77
14	$0.00 - 3,098.33	$3,098.34 - 4,766.66	$4,766.67 - 5,958.33	$5,958.34 - 6,673.33	$6,673.34 - 7,388.33	$7,388.34 - 8,103.33	$8,103.34 - 8,818.33	$8,818.34 - 9,533.80
15	$0.00 - 3,293.33	$3,293.34 - 5,066.66	$5,066.67 - 6,333.33	$6,333.34 - 7,093.33	$7,093.34 - 7,853.33	$7,853.34 - 8,613.33	$8,613.34 - 9,373.33	$9,373.34 - 10,133.83
16	$0.00 - 3,488.33	$3,488.34 - 5,366.66	$5,366.67 - 6,708.33	$6,708.34 - 7,513.33	$7,513.34 - 8,318.33	$8,318.34 - 9,123.33	$9,123.34 - 9,928.33	$9,928.34 - 10,733.86
17	$0.00 - 3,683.33	$3,683.34 - 5,666.66	$5,666.67 - 7,083.33	$7,083.34 - 7,933.33	$7,933.34 - 8,783.33	$8,783.34 - 9,633.33	$9,633.34 - 10,483.33	$10,483.34 - 11,333.89