(1) Except as provided in (2) below, an otherwise eligible individual must make a monthly cost share fee in accordance with the table in (3) below, as a condition of eligibility for benefits under the Medicaid for Workers with Disabilities program. The payment is based on the gross income of the individual only, not the individual's family income. The amount of the payment varies depending on what percentage of the federal poverty level for a family of one the individual's gross income represents.
(2) Indians are not required to pay any cost share fee regardless of their income.
(3) The amount of an individual's cost share fee will be determined using the following table:
|Gross Income as a percentage of federal poverty level (FPL)
||Monthly gross income dollar amount
|Up to 100%
||$01.00 to $903
|Over 100% to 150%
||$903.01 to $1,354
|Over 150% to 200%
||$1,354.01 to $1,805
|Over 200% to 250%
||$1805.01 to $2,256