Income Eligibility Guidelines for 2011
The second qualification is based on income.
| Family Size |
250% Above Federal Poverty Levels |
1 |
$27,225 |
2 |
$36,775 |
3 |
$46,325 |
4 |
$55,875 |
5 |
$65,425 |
6 |
$74,975 |
7 |
$84,525 |
8 |
$94,075 |
For each additional
family member |
$9,350
|
NOTE: 2011 Federal Poverty Guidelines do not include Hawaii and Alaska. Each medication has a defined income guideline. The illustrated 250% is the average.
< Return to Prescription Assistance Program Application home page