What "400% of the federal poverty level" means in 2026

The 2026 numbers

For the 48 contiguous states and Washington, D.C.:

| Household size | 100% FPL | 400% FPL |

|---:|---:|---:|

| 1 | $15,960 | $63,840 |

| 2 | $21,640 | $86,560 |

| 3 | $27,320 | $109,280 |

| 4 | $33,000 | $132,000 |

| 5 | $38,680 | $154,720 |

| 6 | $44,360 | $177,440 |

| 7 | $50,040 | $200,160 |

| 8 | $55,720 | $222,880 |

For each additional person, add $5,680 to the poverty guideline, or $22,720 at 400%. Alaska and Hawaii use higher figures.

Income isn't defined the same way everywhere

The table doesn't tell you which income number a program uses. A PAP may ask for annual gross household income. Marketplace subsidies use modified adjusted gross income and a tax-household framework. Medicaid often looks at current monthly income under state-specific rules. Medicare Extra Help also considers resources. Read the definition on the application you're completing.

Don't switch gross to net income because the lower number fits better. If your current income dropped after the tax year shown on your return, provide the return plus documents showing the change.

Who counts in the household

This also varies. Programs may count a spouse and tax dependents, everyone supported by the household, or people who share income and expenses. Roommates usually aren't household members just because they share an address. A college student may still be part of a parent's tax household. A separated spouse may or may not count depending on the program's definition.

1. Copy the program's exact household definition.

1. List each person who fits it and their relationship to you.

1. Match each included person to their income documentation.

1. Add a short note for unusual situations: separation, shared custody, a dependent living away at school.

Some programs don't use an income ceiling at all

Commercial copay cards often focus on insurance type, not income. Some uninsured cash programs also have no income limit, Sanofi's Valyou program, for example, has been offered to eligible uninsured patients regardless of income. No income limit doesn't mean no eligibility rules, and a cash purchase may not count toward insurance cost sharing.

Use the Glucopath matcher to identify the right category before you start collecting documents.

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