SAMPLE CALCULATIO FOR HE-P 2404.03, FINANCIAL ELIGIBILITY
For example, if a family consists of a husband, wife, and one child, the allowed family income shall be $15,500. If the annual gross income for the entire family is $20,000, the difference of $4,500 shall be multiplied by 80% to determine the amount of medical debt that shall be incurred before the family shall be deemed eligible for financial assistance. Therefore, in this case, $3,600 shall be the amount of medical debt necessary before any CIP funds shall be used to assist.
N.H. Admin. Code He, He-P, ch. He-P 2500, app II