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| Patient Assistance Program Center |
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Persons in |
100% FPL |
135% FPL |
150% FPL |
175% FPL |
200% FPL |
250% FPL |
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1 |
$10,830 |
$14,620 |
$16,245 |
$18,952 |
$21,660 |
$27,075 |
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2 |
14,570 |
19,669 |
21,855 |
25,497 |
29,140 |
36,425 |
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3 |
18,310 |
24,719 |
27,465 |
32,042 |
36,620 |
45,775 |
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4 |
22,050 |
29,767 |
33,075 |
38,587 |
44,100 |
55,125 |
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5 |
25,790 |
34,816 |
38,685 |
45,132 |
51,580 |
64,475 |
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6 |
29,530 |
39,865 |
44,295 |
51,677 |
59,060 |
73,825 |
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7 |
33,270 |
44,914 |
49,905 |
58,222 |
66,540 |
83,175 |
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8 |
37,010 |
49,963 |
55,515 |
64,767 |
74,020 |
92,525 |
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Add for each additional person |
3,740 |
5,049 |
5,610 |
6,545 |
7,480 |
9,350 |
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Persons in Family Unit |
100% FPL |
100% FPL |
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1 |
$13,530 |
$12,460 |
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2 |
18,210 |
16,760 |
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3 |
22,890 |
21,060 |
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4 |
27,570 |
25,360 |
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5 |
32,250 |
29,660 |
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6 |
36,930 |
33,960 |
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7 |
41,610 |
38,260 |
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8 |
46,290 |
42,560 |
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Add for each additional person |
4,680 |
4,300 |
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