Ryan White Income Guidelines & Eligibility

Ryan White Part A and B Eligibility

  • You must have a diagnosis of HIV or AIDS and be low income
  • Before you are eligible for Ryan White funded services, you must use your (or your spouse’s or partner’s) private insurance, or public benefits like Medicare or Medicaid, to pay for the services they cover
  • Many organizations that receive Ryan White funds for services to people with HIV or AIDS also have services funded by other sources--always ask about other services if you don’t meet the income guidelines for Ryan White

 Ryan White Part A and B Eligibility Income Limits

  • Ryan White Part A, Part B and MAI serve Suburban Virginia PLWHA (Persons Living with HIV/AIDS) with family/household incomes, adjusted for family/household size, to 500% of the federal poverty level
  • Suburban Virginia (Part A) is composed of the Cities of Alexandria, Fairfax, Falls Church, Fredericksburg, Manassas, Manassas Park; and the Counties of Arlington, Clarke, Culpeper, Fairfax, Fauquier, King George, Loudoun, Prince William, Spotsylvania, Stafford, and Warren
  • Northern Virginia (Part B) is composed of the Cities of Alexandria, Fairfax, Falls Church, Manassas, Manassas Park; and the Counties of Arlington, Fairfax, Loudoun, and Prince William. Part B gives priority to residents of Northern Virginia but may serve residents of other parts of the state.
  • Family/household means two or more persons sharing living quarters who are related by birth, marriage or adoption, as well as same-sex couple households, and common law households. Roommates, unrelated individuals who share rent and utility bills in exchange for a share of space in a living unit, are not considered part of the PLWHA’s family/household for income determination
  • The federal poverty level (FPL) is updated each year in the Federal Poverty Guidelines. The maximum income for Ryan White is always a percentage of the current poverty level
  • Those with incomes between the poverty level and the maximum income level pay a sliding fee, (a fee that is higher or lower depending on whether your income is higher or lower). See Ryan White Parts A and B Sliding Fee Payment Requirements below.

Maximum Income for Ryan White Part A, B and ADAP Eligibility in Virginia Effective January 15, 2020

Family Size
(count everyone in family/household)
Federal Poverty Level (FPL)
2020
Part A, Part B, MAI and Virginia ADAP
500% of FPL
1
$12,760
$63,800
2
17,240
86,200
3
21,720
108,600
4
26,200
131,000
5
30,160
153,400
6
35,680
175,800
7
39,640
198,200
8
44,120
220,600
Each additional person
4,480
22,400

 *  Note:  500% is the poverty level multiplied by five. Income limits change slightly each year with changes in the FPL


Ryan White Parts A and B Sliding Fee Payment Requirements -
 Fees under Revision - Watch this Space

  • A sliding fee is higher or lower depending on whether your income is higher or lower
  • Service providers who charge for services and provide services that are reimbursable through Medicaid and/or other insurance, must use a sliding fee scale for clients receiving these services through Ryan White funds, either Part A, MAI, or Part B
  • The scale is based on the most current Federal Poverty Guidelines (also known as the federal poverty level or FPL), updated each year 

Part A and B Sliding Fees by Income - Effective January 15, 2020 for Northern Virginia

Family Size
Federal Poverty Level (2017)
200% Poverty Level
300% Poverty Level
Maximum Income for Ryan White Eligibility
1
$12,760
$25,520
$38,280
-
2
17,240
34,480
51,720
Refer to the
3
21,720
43,440
65,160
Table Above
4
26,200
52,400
78,600
 
5
30,680
61,360
9,2040
 
6
35,160
70,320
105,480
 
7
39,640
79,280
118,920
 
8
44,120
88,240
132,360
 
Each additional person
4,480
8,960
13,440
 

 The requirements for charges or sliding fee payments for services are:

  • Clients with an income less than or equal to 100% of the most current federal poverty guidelines will not pay a fee for the provision of services
  • Clients with an income greater than 100% of the most current federal poverty guidelines will pay a fee for the provision of services and will be charged according to a sliding fee scale. The service provider will post the sliding fee scale so that it is visible to clients and the general public


 Caps on Ryan White Charges

  1. Clients with an income greater than 100%, but not exceeding 200% of the most current federal poverty level (FPL) will not, for any calendar year, pay Ryan White charges in an amount exceeding 5% of their annual gross* income
  2. Clients with an income greater than 200%, but not exceeding 300% of the most current FPL will not, for any calendar year, pay Ryan White charges in an amount exceeding 7% of their annual gross* income
  3. Clients with an income greater than 300%, but not exceeding the Maximum Income for Ryan White Eligibility for their family size, will not pay Ryan White charges in an amount exceeding 10% of their annual gross* income in any calendar year

*Gross income is your total income before any expenses are paid

Ryan White services may not be denied to any eligible HIV client based on that client’s inability to pay the charge or sliding fee.