Federal Poverty Level (FPL) - Health Insurance

What Is the Federal Poverty Level (FPL) in Health Insurance?

<lingo>The federal poverty level or FPL is an economic measure, used to determine if an individual is eligible for a range of government benefits and programs. The FPL changes from year to year and can be defined as the average annual income a household would need for basic life necessities, such as shelter, food, clothing, transportation, and more. If an individual or family’s annual household income is below this pre-determined level, they will be considered “below the poverty line.” Generally speaking in this case, they would then become eligible for such benefits and programs as the Children’s Health Insurance Program (CHIP), Family and Planning Services, Medicaid, the National School Lunch Program, Food Stamps, and more.</lingo>

The Federal Poverty Level Clearly and Briefly Explained

The federal poverty level is set yearly by the Department of Health and Human Services (HHS) and is adjusted for inflation. The HHS generally releases the coming year’s FPL in January and bases their new guidelines on the US Census Bureau’s annual public report on overall poverty levels in the nation. This Census Bureau report looks at the numbers of Americans who are at or below the poverty line and considers factors such as age and location, which may influence income. 

<twitter>The federal poverty level or FPL is an economic measure, used to determine if an individual is eligible for a range of government benefits and programs. </twitter>

It’s important to note that the FPL varies, depending on household size and family location. To illustrate, the official FPL is always higher for a family of 5 than it is for a family of 2 or for an individual. Furthermore, if a household is located in Alaska or Hawaii, the FPL will always be higher because the cost of living in these locations is higher. 

When it comes to determining specific eligibility for government benefits and programs, certain states consider income after tax while others look at income before tax. A household does not have to have an income wholly below the FPL to be eligible for government assistance. For instance, some government programs like Medicaid consider eligibility to be household incomes below 138% of the federal poverty line (in states with expanded Medicaid coverage).

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