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Household Income Table


Income Eligibility for the Children's Special Health Care Services (CSHCS) Program
Based on Health and Human Service Poverty Income Guidelines

Effective January 13, 2021

To be financially eligible for CSHCS, the gross household income must be less than or equal to 250% of the federal poverty income guidelines.  Household means a group of related or non-related individuals who are not residents of an institution, but who are living as one economic unit.  The applicant must also be medically eligible to receive services.


Effective July 1, 2010, the CSHCS Program began counting Supplemental Security Income (SSI) and Adoption Assistance Program (AAP) payments as income to evaluate CSHCS participants initial and ongoing financial eligibility for the program.

NOTE: CSHCS defines a pregnant woman as one family member