- Individuals 60 years and older (must be 60 years old on the day the coupons are received
- Individuals who meet the income guidelines for your household (see chart below)
| Size | Annual | Monthly |
| 1 | $28,920 | $2,413 |
| 2 | 39,127 | 3,261 |
| 3 | 49,302 | 4,109 |
| 4 | 59,477 | 4,956 |
| 5 | 69,652 | 5,804 |
| 6 | 79,827 | 6,652 |
| 7 | 90,002 | 7,500 |
| 8 | 100,177 | 8,348 |
*Individuals must complete and sign the Statement of Eligibility form to receive the coupons.*
