What are the Federal Poverty Levels (FPL)?

By healthsherpa

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In shopping for Marketplace health insurance and learning if you might qualify for certain health insurance tax subsidies, Medicaid, or CHIP you’ll hear a lot about the Federal Poverty Level (FPL). Where your annual household income and household size stands relative to the FPL (also known as the federal poverty guidelines) will mean a lot in terms of what is available to you on the Marketplace. The Federal Poverty Level is defined as a measure of income issued every year by the Department of Health and Human Services (HHS). To learn more about getting insurance, grab our guide to getting Marketplace insurance here.

Federal Poverty Level amounts for 2020

The 2020 federal poverty level (FPL) income numbers below are used to calculate eligibility for Medicaid and the Children’s Health Insurance Program (CHIP) based on annual household income. They are based on family size and are set as follows by HHS for all states except Alaska and Hawaii:

• $12,760 for individuals
• $17,240 for a family of 2
• $21,720 for a family of 3
• $26,200 for a family of 4
• $30,680 for a family of 5
• $35,160 for a family of 6
• $39,640 for a family of 7
• $44,120 for a family of 8

Add $4,480 for each additional person if your family/household is more than 8 people. There are no adjustments for cost of living in the 48 contiguous states.

Federal Poverty Level amounts are higher in Alaska and Hawaii. Alaska starts at $15,950 for one person and Hawaii starts at $14,680 for one person. You can read more about the FPL guidelines set by HHS here. 

To see if you’re eligible for a subsidy to lower the cost of health insurance, or if you’re eligible for Medicaid, enter your zip code below.

If you aren’t eligible for free or subsidized health insurance and you can’t afford a Marketplace plan (aka Obamacare or Affordable Care Act insurance), check out our post on what to do if you fall into the Medicaid gap and our guide to finding a free clinic. You can also call us for help enrolling in health insurance at (872) 228-2549.

Important Federal Poverty Level Cut-Offs

The FPL for a given calendar year plays a key factor in determining eligibility for reduced-cost health care and health insurance. As described in the Affordable Care Act, certain percentages at, above, and below the Federal Poverty Level are used to determine certain qualifiers for everything from Marketplace subsidies to Medicaid. These are the big FPL cut-offs to know:

• Annual income between 100% and 400% of the FPL: In all states, if your income level is in this range, you will qualify for premium tax credits for ACA health coverage. These special tax subsidies lower your monthly premium for a Marketplace health insurance plan.
• Annual income below 138% of the FPL: This is the income limit for Medicaid in certain states. If your state has expanded Medicaid coverage and your income is below 138% FPL, you can qualify for Medicaid based only on your income. There are some other ways to qualify for Medicaid—you can see if you qualify for Medicaid here. 
• Annual income below 100% of the FPL: If your state has expanded Medicaid coverage, you’ll qualify for Medicaid with an income under 138% of the FPL, but if your state has not expanded Medicaid, you may fall into the Medicaid gap if your income is under 100% of the FPL. If you are 65 or older or disabled, and your income is under 100% of the FPL, your state must pay for Medicare on your behalf through the Qualifying Medicare Beneficiary (QMB) program.

Here are the 2020 federal poverty line cutoffs for the 48 contiguous states and District of Columbia.