| Each 1 Add | $5,680 | $8,520 | $11,360 |
| Poverty Level | 100% | 150% | 200% |
| Client Portion | 0% | 25% | 50% |
| 1 – In Household | $15,960 | $23,940 | $31,920 |
| 2 – In Household | $21,640 | $30,660 | $40,880 |
| 3 – In Household | $27,320 | $38,730 | $51,640 |
| 4 – In Household | $33,000 | $49,500 | $66,000 |
| 5 – In Household | $38,680 | $58,020 | $77,360 |
| 6 – In Household | $44,360 | $$66,540 | $88,720 |
| 7 – In Household | $50,040 | $75,060 | $100,080 |
| 8- In household | $55,720 | $83,580 | $111,440 |
To calculate the sliding fee scale percentage rate, take the total gross yearly income, add (if applicable) the number of people in household (the number 1 to 8 column), and find income amount on the chart that closely matches. This will give you the percentage rate.
Example: $ 52,000 income, 4 people in the household rate would be 25%.
Individuals at the 0% poverty rate need to fill out a Medicaid application.