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federal poverty level (FPL) / federal poverty guidelines

What is the federal poverty level (federal poverty guidelines)?

healthinsurance.org health insurance glossary

The federal poverty level (FPL) is commonly used to refer to the federal poverty guidelines that HHS issues each year. (Although HHS notes that “federal poverty guidelines” is actually the correct terminology, and that “federal poverty level” should be avoided, the latter tends to be more frequently used.)

It’s specified as an income amount that is used to determine eligibility for various income-based public programs, such as Medicaid, health insurance premium tax credits, and cost-sharing reductions. The specific dollar amount varies based on the number of people in the household and whether the household is in Alaska, Hawaii, or the continental U.S.

The following charts show federal poverty guidelines for 20231 and 2024,2 both of which will be used for various healthcare programs in 2024 and 2025 (more details below in terms of which numbers are used for which programs).

2024 Federal Poverty Guidelines
Persons in family / household 48 contiguous states and DC Alaska Hawaii
1 $15,060 $18,810 $17,310
2 $20,440 $25,540 $23,500
3 $25,820 $32,270 $29,690
4 $31,200 $39,000 $35,880
5 $36,580 $45,730 $42,070
6 $41,960 $52,460 $48,260
7 $47,340 $59,190 $54,450
8 $52,720 $65,920 $60,640
9+ If more than 8 in household / family, add $5,380 per additional person. If more than 8 in household / family, add $6,730 per additional person. If more than 8 in household / family, add $6,190 per additional person.
2023 Federal Poverty Guidelines
Persons in family / household 48 contiguous states and DC Alaska Hawaii
1 $14,580 $18,210 $16,770
2 $19,720 $24,640 $22,680
3 $24,860 $31,070 $28,590
4 $30,000 $37,500 $34,500
5 $35,140 $43,930 $40,410
6 $40,280 $50,360 $46,320
7 $45,420 $56,790 $52,230
8 $50,560 $63,220 $58,140
9+ If more than 8 in household / family, add $5,140 per additional person. If more than 8 in household / family, add $6,430 per additional person. If more than 8 in household / family, add $5,910 per additional person.

How is the FPL used in healthcare?

The federal poverty level is used to determine

Medicaid and CHIP:

  • For Medicaid and CHIP eligibility determinations, the current year’s federal poverty level numbers are used (and are compared with the household’s current monthly or annual income — enrollees can use either one). The poverty level numbers are updated by HHS each year in mid-late January, although states typically don’t start to use the new numbers for Medicaid eligibility determination until March or April (states can begin even earlier; for example, Wisconsin switched to the 2023 poverty level numbers as of February 1, 2023).
  • In states that have expanded Medicaid, adults under the age of 65 will qualify for Medicaid if they earn up to 138% of the FPL. (Note that although you’ll often see this written as 133%; there’s a 5% income disregard that effectively brings it up to 138%.)
  • Children and people who are pregnant are eligible for Medicaid or CHIP at higher income levels; the specific thresholds vary by state.
  • In states that haven’t expanded Medicaid, the eligibility guidelines are stricter, with much lower income limits for parents and coverage generally not available at all to non-disabled childless adults, regardless of how low their income is. This creates a coverage gap that exists in nine states as of 2024.
  • For people who are disabled or 65+, Medicaid eligibility also depends on assets (varies by state; click on a state on this map to see details).
  • CHIP eligibility is also based on the federal poverty level, but the specific thresholds vary from one state to another.

Premium tax credits:

  • For premium tax credit eligibility determinations, the prior year’s FPL numbers are used, and are compared with the applicant’s projected total annual income for the year the coverage will be in force. So for a plan with a 2024 effective date, the household’s projected total 2024 income is compared with the 2023 poverty level numbers.
  • If you’re in a state that has expanded eligibility for Medicaid, premium tax credit (premium subsidy) eligibility in the marketplace/exchange starts above 138% of the federal poverty level (ie, where Medicaid ends). It used to end at 400% of the poverty level (or lower, if the coverage was already considered affordable without a subsidy) but the American Rescue Plan temporarily eliminated that income limit, and the Inflation Reduction Act has extended that provision through 2025. So for the time being, premium tax credits are available regardless of income, if the cost of the benchmark plan would otherwise be more than 8.5% of the household’s income.
  • If you’re in a state that has not expanded Medicaid (10 states have not expanded Medicaid as of early 2024), premium tax credit eligibility starts at 100% of the federal poverty level. And as is the case in the rest of the states, there is not an upper income limit for premium subsidy eligibility through 2025. So a person who earns 120% of the poverty level would qualify for Medicaid in some states (ie, states that have expanded Medicaid) and for premium subsidies in others (ie, states that have not expanded Medicaid).
  • It’s important to note that children are eligible for Medicaid or CHIP at much higher household incomes than the Medicaid eligibility limits for adults. So it’s common to see households where the kids are eligible for Medicaid or CHIP, while the parents are eligible for premium tax credits instead. If the family chooses to enroll the kids along with the parents on the private plan in the exchange, they have to pay full price for the kids’ coverage, since they could have enrolled in Medicaid or CHIP instead.
  • If you’re a recent immigrant who is not eligible for Medicaid due to your immigration status, eligibility for federal premium tax credits extends down to 0% of the poverty level.
  • Use our calculator to estimate how much you could save on your ACA-compliant health insurance premiums.

Cost-sharing reductions:

  • Cost-sharing reductions are available to marketplace/exchange enrollees who select Silver plans and whose household income doesn’t exceed 250% of the FPL. But cost-sharing reductions are strongest for households with income that doesn’t exceed 200% of the poverty level.
  • As is the case with premium tax credits, the household’s projected income is compared with the prior year’s poverty level numbers to determine eligibility for cost-sharing reductions.
  • As is the case for premium tax credits, the lower eligibility threshold is 100% of the poverty level in states that have not expanded Medicaid, and above 138% in states that have.
  • For coverage effective in 2024, 250% of the federal poverty level in the continental U.S. is $36,450 for a single individual, $62,150 for a family of three, and $100,700 for a family of six. (The amounts are higher in Alaska and Hawaii, since they have higher federal poverty levels).
  • For coverage effective in 2025, 250% of the federal poverty level in the Continental U.S. will be $37,650 for a single individual, $64,550 for a family of three, and $104,900 for a family of six.

Medicare Savings Programs and Part D Low-Income Subsidy:

  • Medicare beneficiaries with limited financial means can qualify for Medicare Savings Programs, with eligibility that depends on income being within a specified percentage of the FPL, as well as asset limits.
  • The Medicare Part D Low-Income Subsidy (Extra Help) depends on income (no more than 150% of the poverty level) and assets. As of 2024, under the Inflation Reduction Act, people who were previously eligible only for partial Extra Help are eligible for full Extra Help (ie, there is no longer full or partial eligibility; everyone eligible for Extra Help is eligible for the full benefit).

The calculator below is currently using the 2023 FPL numbers, regardless of whether you select Medicaid/CHIP or Marketplace subsidy eligibility determination. That’s because most states won’t switch over to using the 2024 FPL numbers for Medicaid/CHIP eligibility determination until March or April 2024. At that point, we’ll adjust the calculator so that it uses the 2024 numbers when you select Medicaid/CHIP.

Federal poverty level calculator

Footnotes

  1. HHS Poverty Guidelines for 2024. U.S. Department of Health and Human Services. Published January 2024. 
  2. 2023 Poverty Guidelines. U.S. Department of Health and Human Services. Published January 2023. 

Which federal agency determines the federal poverty guidelines?

The federal poverty guidelines are set each year by the Department of Health and Human Services (as opposed to the poverty threshold, which is set by the Census Bureau and used for statistical purposes rather than for the administration of income-based federal programs).

Does the FPL vary from one state to another?

The federal poverty level is higher in Alaska and Hawaii. HHS sets three different amounts each year: One for the continental United States, a higher level for Hawaii, and an even higher level for Alaska. But within the continental U.S., the federal poverty level does not vary.

When does the FPL change each year?

HHS publishes updated FPL numbers in mid-January each year. Agencies use this new amount soon thereafter (no later than April 1) to determine eligibility for Medicaid and CHIP. But the prior year’s FPL numbers continue to be used to determine eligibility for premium tax credits and cost-sharing reductions until open enrollment starts again in the fall.

So for example, if a person applies for Medicaid in June 2024, their current household income would be compared with the 2024 FPL amount. But if they qualify for a special enrollment period and apply for an individual-market plan through the marketplace, the marketplace will compare their total projected 2024 household income (including what they’ve already earned in 2024 and what they expect to earn for the rest of the year) with the 2023 FPL amount for their household size.

When a consumer applies for a plan in the marketplace, the marketplace checks the applicant’s eligibility for Medicaid and CHIP eligibility first. If a person is eligible for Medicaid or CHIP, they are not eligible for premium subsidies for a marketplace plan. But assuming they’re not eligible for Medicaid or CHIP, the marketplace will then determine whether they’re eligible for premium subsidies, and if so, the size of the subsidy.

What is the FPL that's used for 2024 health coverage?

The 2023 poverty level numbers, published in January, 2023, are used to determine subsidy eligibility for 2024 coverage. For a single person in the continental United States, the 2023 federal poverty level is $14,580. For each additional person in the household, the federal poverty level increases by $5,140. (So for a household of three, for example, the 2023 federal poverty level is $24,860.)

But to determine 2024 eligibility for Medicaid and CHIP, states switched to the 2024 FPL numbers by March or April 2024. For private health plans, the Marketplaces will start to use the 2024 FPL numbers in November 2024, when subsidy eligibility is being calculated for 2025 coverage.

How are the FPL numbers for subsidy eligibility different in Alaska and Hawaii?

The FPL numbers are higher in Alaska and Hawaii than they are in the rest of the United States. Both Alaska and Hawaii have expanded Medicaid eligibility under the ACA, so Medicaid is available to adults under the age of 65 if their household income doesn’t exceed 138% of FPL. Premium subsidy eligibility in both states starts above 138% of FPL, which is a different dollar amount in Alaska and Hawaii, since they have different federal poverty levels.

  • The 2023 federal poverty level for a single person in Hawaii is $16,770, with an increase of $5,910 for each additional member of the household. For a single person in Alaska, the 2023 federal poverty level is $18,210, with an increase of $6,430 for each additional person in the household. These numbers are used to determine subsidy eligibility for private plans with 2024 effective dates.
  • The 2024 FPL for a single person is $17,310 in Hawaii and $18,810 in Alaska. These numbers are used to determine Medicaid/CHIP eligibility in 2024 (until the states transition to the new 2025 numbers in early 2025).

You can see the 2023 and 2024 federal poverty levels at the top of this page, with amounts based on family size and location.

The 2023 poverty level numbers are still used to determine subsidy eligibility for people enrolling in 2024 coverage due to a qualifying life event such as losing other coverage, getting married, or having a baby. The 2024 numbers are already in use for Medicaid/CHIP eligibility determinations, and will be used for marketplace subsidy eligibility starting November 1, 2024, during open enrollment for 2025 coverage.

When and why was the FPL established?

The federal poverty thresholds were first introduced in 1965, based on the work of the Social Security Administration’s Mollie Orshansky. The amounts were tied to the bare minimum amount that people needed in order to have adequate food, with a multiplier used to account for other necessary expenses. Orshansky noted at the time that the poverty thresholds were a measure of the amount of income that would be inadequate for people to live, as opposed to a minimum adequate amount.

By the late 1960s, the federal poverty guidelines began to be indexed based on the Consumer Price Index. And other changes have been made over the years as well, such as eliminating the separate poverty level guidelines for farm families in the early 1980s.

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