Plans
Guidelines
2009 Health and Human Services Poverty Guidelines
| Size of Family Unit | 48 Contiguous | Alaska | Hawaii |
|---|---|---|---|
| 1 | $10,830 | $13,530 | $12,460 |
| 2 | $14,570 | $18,210 | $16,760 |
| 3 | $18,310 | $22,890 | $21,060 |
| 4 | $22,050 | $27,570 | $25,360 |
| 5 | $25,790 | $32,250 | $29,660 |
| 6 | $29,530 | $36,930 | $33,960 |
| 7 | $33,270 | $41,610 | $38,260 |
| 8 | $37,010 | $46,290 | $42,560 |
| For each additional person, add | $3,740 | $4,680 | $4,300 |
2009 Estimated Income Requirements for a household at or below 135% of the Federal Poverty Guidelines. SOURCE: Federal Register, Vol. 74, No. 14, January 23, 2009, pp. 4199-4201
Documentation
Acceptable documentation of income eligibility includes:
- The prior year's state, federal, or tribal tax return
- Three consecutive months worth of income statement from an employer or paycheck stubs within the current calendar year
- A Social Security statement of benefits
- A Veterans Administration statement of benefits
- A retirement/pension statement of benefits
- An Unemployment/Workmen's Compensation statement of benefits, federal or tribal notice letter of participation in General Assistance
- A divorce decree, child support, or other official document.
