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 MAP (ADAP) Eligibility in Virginia Effective January 15, 2021

Family Size
(count everyone in family/household)
Federal Poverty Level (FPL)
2021
Part A, Part B, MAI and Virginia MAP (ADAP)
500% of FPL
1
$12,880
$64,400
2
17,420
87,100
3
21,960
109,800
4
26,500
132,500
5
31,040
155,200
6
35,580
177,900
7
40,120
200,600
8
44,660
223,300
Each additional person
4,540
22,700

 *  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 (2021)
200% Poverty Level
300% Poverty Level
Maximum Income for Ryan White Eligibility
1
$12,880
$25,760
$38,640
-
2
17,420
34,840
52,260
Refer to the
3
21,960
43,920
65,880
Table Above
4
26,500
53,000
79,500
 
5
31,040
62,080
93,120
 
6
35,580
71,160
106,740
 
7
40,120
80,240
120,360
 
8
44,660
89,320
133,980
 
Each additional person
4,540
9,080
13,620
 

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

  • Clients with a family 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 a family 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 individual 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 individual 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 individual income greater than 300%, but not exceeding the Maximum Income for Ryan White Eligibility, 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.