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Emergency Respite Care for Children with Special Needs and Their Parents (1.19 MB PDF)
Library of all DMA Consumer Publications
All DHHS Programs and Services
Your family’s monthly income must be equal to or less than 200% of the federal income limits.
If your family’s monthly income is slightly over the income limits listed below, your child(ren) may still be eligible. There are deductions for child care and a $90 work-related expense deduction for each family member who works.
| Family Size | 200% (a) | 150% (b) | ||
|---|---|---|---|---|
| Monthly Income | Annual Income | Monthly Income | Annual Income | |
| 1 | $1,805 | $21,660 | $1,354 | $16,245 |
| 2 | $2,429 | $29,140 | $1,822 | $21,855 |
| 3 | $3,052 | $36,620 | $2,289 | $27,465 |
| 4 | $3,675 | $44,100 | $2,757 | $33,075 |
| 5 | $4,299 | $51,580 | $3,224 | $38,685 |
| 6 | $4,922 | $59,060 | $3,692 | $44,295 |
| 7 | $5,545 | $66,540 | $4,159 | $49,905 |
| 8 | $6,169 | $74,020 | $4,627 | $55,515 |
(a) For each additional family member add $624 a month
(b) For each additional family member add $468 per month
Once a child has been covered under this plan, if your family economic conditions change so that the child is no longer eligible, but you want the child to continue in the program, you may be allowed to purchase the plan at full premium for one year.
If your monthly income is above the 150% poverty level, there is an enrollment fee of $50 for one child or $100 for two or more children.
If your monthly income is at or below the 150% poverty level, there is no enrollment fee.
If your monthly income is above the 150% of poverty level, there are co-pays:
If your monthly income is 150% of poverty and below, you only have co-pays for prescription drugs: $1 for a generic drug, $1 for a brand drug for which no generic is available, and $3.00 for brand drug for which there is a generic available.
