Family Size

ARKids A

Children 6 & Over &

AR Health Care Access

100%

ARKids A Children Under Age 6

133%

Transitional Medicaid

185%

SOBRA

Pregnant Women, Family Planning &

ARKids First B

200%

1

902.50

1200.33

1669.63

1805.00

2

1214.17

1614.85

2246.21

2428.34

3

1525.83

2029.35

2822.79

3051.66

4

1837.50

2443.88

3399.38

3675.00

5

2149.17

2858.40

3975.96

4298.34

6

2460.83

3272.90

4552.54

4921.66

7

2772.50

3687.43

5129.13

5545.00

8

3084.17

4101.95

5705.71

6168.34

9

3395.84

4516.47

6282.30

6791.68

10

3707.51

4930.99

6858.89

7415.02

For each additional member add:

311.67

414.52

576.59

623.34

ARSeniors

Equal to or Below

80%

QMB

Equal To or Below

100%

SMB

Between 100% & 120%

QI-1

At least 120% but Less Than 135%

QDWI & TB

Equal To or Below

200%

Working Disabled 250%

Individual

722.00

902.50

1083.00

1218.38

1805.00

2256.25

Couple

971.34

1214.17

1457.00

1639.13

2428.34

3035.42

For each additional family member in the Working Disabled category add:

779.18

Family Size

ARKids A

Children 6 & Over &

AR Health Care Access

100%

ARKids A Children Under Age 6

133%

Transitional Medicaid

185%

SOBRA

Pregnant Women, Family Planning &

ARKids First B

200%

1

866.67

1152.67

1603.33

1733.34

2

1166.67

1551.67

2158.33

2333.34

3

1466.67

1950.67

2713.33

2933.34

4

1766.67

2349.67

3268.33

3533.34

5

2066.67

2748.67

3823.33

4133.34

6

2366.67

3147.67

4378.33

4733.34

7

2666.67

3546.67

4933.33

5333.34

8

2966.67

3945.67

5488.33

5933.34

9

3266.67

4344.67

6043.33

6533.34

10

3566.67

4743.67

6598.33

7133.34

For each additional member add:

300.00

399.00

555.00

600.00

ARSeniors

Equal to or Below

80%

QMB

Equal To or Below

100%

SMB

Between 100% & 120%

QI-1

At least 120% but Less Than 135%

QDWI & TB

Equal To or Below

200%

Working Disabled 250%

Individual

693.33

866.67

1040.00

1170.00

1733.34

2166.67

Couple

933.33

1166.67

1400.00

1575.00

2333.34

2916.67

For each additional family member in the Working Disabled category add:

750.00

Family Size

ARKids A

Children 6 & Over &

AR Health Care Access

100%

ARKids A Children Under Age 6

133%

Transitional Medicaid

185%

SOBRA

Pregnant Women, Family Planning &

ARKids First B

200%

1

850.83

1131.60

1574.04

1701.66

2

1140.83

1517.30

2110.54

2281.66

3

1430.83

1903.00

2647.04

2861.66

4

1720.83

2288.70

3183.54

3441.66

5

2010.83

2674.40

3720.04

4021.66

6

2300.83

3060.10

4256.54

4601.66

7

2590.83

3445.80

4793.04

5181.66

8

2880.83

3831.50

5329.54

5761.66

9

3170.83

4217.20

5866.04

6341.66

10

3460.83

4602.90

6402.54

6921.66

For each additional member add:

290.00

385.70

536.50

580.00

ARSeniors

Equal to or Below

80%

QMB

Equal To or Below

100%

SMB

Between 100% & 120%

QI-1

At least 120% but Less Than 135%

QDWI & TB

Equal To or Below

200%

Working Disabled 250%

Individual

680.66

850.83

1021.00

1148.62

1701.66

2127.08

Couple

912.66

1140.83

1369.00

1540.12

2281.66

2852.08

For each additional family member in the Working Disabled category add:

725.00

Family Size

ARKids A

Children 6 & Over &

AR Health Care Access

100%

ARKids A Children Under Age 6

133%

Transitional Medicaid

185%

SOBRA

Pregnant Women, Family Planning &

ARKids First B

200%

1

816.67

1086.17

1510.84

1633.34

2

1100.00

1463.00

2035.00

2200.00

3

1383.33

1839.83

2559.16

2766.66

4

1666.67

2216.67

3083.34

3333.34

5

1950.00

2593.50

3607.50

3900.00

6

2233.33

2970.33

4131.66

4466.66

7

2516.67

3347.17

4655.84

5033.34

8

2800.00

3724.00

5180.00

5600.00

9

3083.33

4100.83

5704.16

6166.66

10

3366.66

4477.66

6228.32

6733.32

For each additional member add:

283.33

376.83

524.16

566.66

ARSeniors

Equal to or Below

80%

QMB

Equal To or Below

100%

SMB

Between 100% & 120%

QI-1

At least 120% but Less Than 135%

QDWI & TB

Equal To or Below

200%

Working Disabled 250%

Individual

653.34

816.67

980.00

1102.50

1633.34

2041.68

Couple

880.00

1100.00

1320.00

1485.00

2200.00

2750.00

For each additional family member in the Working Disabled category add:

708.33

Family Size

ARKids A

Children 6 & Over &

AR Health Care Access

100%

ARKids A Children Under Age 6

133%

Transitional Medicaid

185%

SOBRA

Pregnant Women, Family Planning &

ARKids First B

200%

1

797.50

1060.68

1475.38

1595.00

2

1069.17

1422.00

1977.96

2138.34

3

1340.83

1783.30

2480.54

2681.66

4

1612.50

2144.63

2983.13

3225.00

5

1884.17

2505.95

3485.71

3768.34

6

2155.83

2867.25

3988.29

4311.66

7

2427.50

3228.58

4490.88

4855.00

8

2699.17

3589.90

4993.46

5398.34

9

2970.84

3951.22

5496.05

5941.68

10

3242.51

4312.54

5998.64

6485.02

For each additional member add:

271.67

361.32

502.59

543.34

ARSeniors

Equal to or Below

80%

QMB

Equal To or Below

100%

SMB

Between 100% & 120%

QI-1

At least 120% but Less Than 135%

QDWI & TB

Equal To or Below

200%

Working Disabled 250%

Individual

638.00

797.50

957.00

1076.63

1595.00

1993.75

Couple

855.34

1069.17

1283.00

1443.38

2138.34

2672.93

For each additional family member in the Working Disabled category add:

679.18

Family Size

ARKids A

Children 6 & Over &

AR Health Care Access

100%

ARKids A Children Under Age 6 &

133%

Transitional      Medicaid     

185%

SOBRA

Pregnant Women, Family Planning &

ARKids First B

200%

1

775.83

1031.85

1435.29

1551.66

2

1040.83

1384.30

1925.54

2081.66

3

1305.83

1736.75

2415.79

2611.66

4

1570.83

2089.20

2906.04

3141.66

5

1835.83

2441.65

3396.29

3671.66

6

2100.83

2794.10

3886.54

4201.66

7

2365.83

3146.55

4376.79

4731.66

8

2630.83

3499.00

4867.04

5261.66

9

2895.83

3851.45

5357.29

5791.66

10

3160.83

4203.90

5847.54

6321.66

For each additional member add:

265.00

352.45

490.25

530.00

Family Size

ARKids A

Children 6 & Over &

AR Health Care Access

100%

ARKids A Children Under Age 6 &

Family Planning

133%

Transitional Medicaid

185%

SOBRA

Pregnant Women, Family Planning &

ARKids First B

200%

1

748.33

995.28

1384.42

1496.66

2

1010.00

1343.30

1868.50

2020.00

3

1271.67

1691.32

2352.58

2543.34

4

1533.33

2039.33

2836.67

3066.66

5

1795.00

2387.35

3320.75

3590.00

6

2056.67

2735.37

3804.83

4113.34

7

2318.33

3083.38

4288.92

4636.66

8

2580.00

3431.40

4773.00

5160.00

9

2841.67

3779.42

5257.09

5683.34

10

3103.34

4127.44

5741.18

6206.68

For each additional member add:

261.67

348.02

484.09

523.34

ARSeniors

Equal to or Below

80%

QMB

Equal To or Below

100%

SMB

Between 100% & 120%

QI-1

At least 120% but Less Than 135%

QDWI

Equal To or Below

200%

Working Disabled 250%

Individual

598.66

748.33

898.00

1010.25

1496.66

1870.82

Couple

808.00

1010.00

1212.00

1363.50

2020.00

2525.00

For each additional family member in the Working Disabled category add:

654.17

Family Size

ARKids A

Children 6 & Over &

AR Health Care Access

100%

ARKids A Children Under Age 6 &

Family Planning

133%

Transitional Medicaid

185%

SOBRA

Pregnant Women &

ARKids First B

200%

1

738.33

981.98

1,365.92

1,476.66

2

995.00

1,323.35

1,840.75

1,990.00

3

1,251.67

1,664.72

2,315.58

2,503.34

4

1,508.33

2,006.08

2,790.25

3,016.66

5

1,765.00

2,347.45

3,265.25

3,530.00

6

2,021.67

2,688.82

3,740.08

4,043.34

7

2,278.33

3,030.18

4,214.92

4,556.66

8

2,535.00

3,371.55

4,689.75

5,070.00

9

2,791.67

3,712.92

5,164.59

5,583.34

10

3,048.34

4,054.29

5,639.43

6,096.68

For each additional member add:

256.67

341.37

474.84

513.34

ARSeniors

Equal to or Below

80%

QMB

Equal To or Below

100%

SMB

Between 100% & 120%

QI-1

At least 120% but Less Than 135%

QDWI

Equal To or Below

200%

Working Disabled 250%

Individual

590.66

738.33

886.00

996.75

1,476.67

1,845.82

Couple

796.00

995.00

1,194.00

1,343.25

1,990.00

2,487.50

For each additional family member in the Working Disabled category add:

641.67

Family Size

ARKids A

Children 6 & Over Born After 9/30/82

&

AR Health Care Access

100%

ARKids A Children up to Age 6

&

Family Planning

133%

Transitional Medicaid

185%

SOBRA

Pregnant Women

&

ARKids First B

200%

1

715.83

952.05

1,324.29

1,431.66

2

967.50

1,286.78

1,789.88

1,935.00

3

1,219.17

1,621.50

2,255.46

2,438.34

4

1,470.83

1,956.20

2,721.04

2,941.66

5

1,722.50

2,290.93

3,186.63

3,445.00

6

1,974.17

2,625.65

3,652.21

3,948.34

7

2,225.83

2,960.35

4,117.79

4,451.66

8

2,477.50

3,295.08

4,583.38

4,955.00

9

2,729.17

3,629.80

5,048.96

5,458.34

10

2,980.84

3,964.52

5,514.54

5,961.68

For each additional member add:

251.67

334.72

465.58

503.34

QMB

Equal To or Below 100%

SMB

Between 100% & 120%

QI-1

At least 120% but Less Than 135%

QI-2

At least 135% but Less Than 175%

QDWI

Equal To or Below 200%

Working Disabled 

250%

Individual

715.83

859.00

966.37

1,252.70

1,431.67

1,789.57

Couple

967.50

1,161.00

1,306.13

1,693.13

1,935.00

2,418.75

For each additional family member in the Working Disabled category add:

629.18

Family Size

SOBRA
Children 6 & Over Born After 9/30/82
&
AR Health Care Access

100%

SOBRA
Pregnant Women, Infants and Children up to Age 6
&
Family Planning

133%

Transitional Medicaid

185%

ARKids First

200%

1

695.83

925.45

1,287.29

1,391.66

2

937.50

1,246.88

1,734.38

1,875.00

3

1,179.17

1,568.30

2,181.46

2,358.34

4

1,420.83

1,889.70

2,628.54

2,841.66

5

1,662.50

2,211.13

3,075.63

3,325.00

6

1,904.17

2,532.55

3,522.71

3,808.34

7

2,145.83

2,853.95

3,969.79

4,291.66

8

2,387.50

3,175.38

4,416.88

4,775.00

9

2,629.17

3,496.80

4,863.96

5,258.34

10

2,870.83

3,818.20

5,311.04

5,741.66

For each additional member add:

241.67

321.42

447.09

483.34

QMB
Equal To or Below
100%

SMB
Between 100% &
120%

QI-1
At least 120% but Less Than
135%

QI-2
At least 135% but Less Than
175%

QDWI
Equal To or Below
200%

Individual

695.83

835.00

939.37

1,217.70

1,391.66

Couple

937.50

1,125.00

1,265.63

1,640.63

1,875.00

Family Size

SOBRA
Children 6 & Over Born After 9/30/82
&
AR Health Care Access

100%

SOBRA
Pregnant Women, Infants and Children up to Age 6
&
Family Planning

133%

Transitional Medicaid

185%

ARKids First

200%

1

686.67

913.27

1,270.34

1,373.34

2

921.67

1,225.82

1,705.09

1,843.34

3

1,156.67

1,538.37

2,139.84

2,313.34

4

1,391.67

1,850.92

2,574.59

2,783.34

5

1,626.67

2,163.47

3,009.34

3,253.34

6

1,861.67

2,476.02

3,444.09

3,723.34

7

2,096.67

2,788.57

3,878.84

4,193.34

8

2,331.67

3,101.12

4,313.59

4,663.34

9

2,566.67

3,413.67

4,748.34

5,133.34

10

2,801.67

3,726.22

5,183.09

5,603.34

For each additional member add:

235.00

312.55

434.75

470.00

QMB
Equal To or Below
100%

SMB
Between 100% &
120%

QI-1
At least 120% but Less Than
135%

QI-2
At least 135% but Less Than
175%

QDWI
Equal To or Below
200%

Individual

686.67

824.00

927.00

1,201.67

1,373.34

Couple

921.67

1,106.00

1,244.25

1612.92

1,843.34