Adult Medicaid Manual MA-2250 INCOME

REVISED 02/01/08 – CHANGE NO. 07-08

I. POLICY RULEs

A. Available Income

1. To determine eligibility, count income available to the budget unit in the certification period. Refer to MA-2260, Financial Eligibility Regulations-PLA, MA-2270, Long-Term Care (LTC) Need and Budgeting, MA-2280, Community Alternatives Program Medicaid Eligibility, and MA-2275, Program of All-Inclusive Care for the Elderly (PACE) for definition of financial responsibility/deeming.

2. Consider income available to the budget unit when:

a. It is determined to be available based upon base period projections or verification of benefits received, or

b. The budget unit member or someone acting on his behalf has the legal ability to make a sum available for support and maintenance.

c. Income from a financially responsible person (spouse or parent), must be deemed to the a/r.

3. LTC or PACE applicant or recipient (a/r) with a Community Spouse

The following rules apply in determining the availability of income for Steps I and II of LTC and PACE budgeting.

a. Trust Fund Income

(1) Determine the availability of income according to the terms of the trust.

(2) If there is no specific provision in the trust, determine availability of income according to regulations in b. below.

b. Income Not From a Trust Fund

(1) If payment of income is made solely in the name of the institutionalized spouse or the community spouse, consider the income available to that respective spouse.

REVISED 02/01/08-CHANGE NO. 07-08

(I.A.3.b.)

(2) If payment of income is made in both names to the institutionalized and community spouses consider 1/2 of the income available to each spouse.

(3) If payment of income is made to the institutionalized and community spouse, and to another person or persons, consider the income available to each spouse in proportion to each spouse's interest.

(4) In Step II only of LTC or PACE budgeting

Determine if the community spouse income allowance should be given. Refer to MA-2270 , Long-Term Care Need and Budgeting and MA-MA-2275, Program of All-Inclusive Care for the Elderly (PACE).

B. Computation

Determine the available income of a/r. Deem income from a financially responsible person (spouse or parent), when appropriate. Subtract appropriate exclusions, including the infrequent or irregular income exclusion, to determine countable income.

Refer to IX. below for computation outline and MA-2260 , Financial Eligibility Regulations, PLA for budgeting/deeming procedures.

C. Consideration of Income

1. Count all income available in the certification period. Refer to V. below for budgeting terminated income.

2. Count income available to the a/r or a financially responsible person (spouse or parent), per budgeting/deeming instructions.

3. Refer to MA-2270, Long Term Care Need and Budgeting for instructions on allowable deductions in Step II of patient monthly liability computation in LTC budgeting. Count total adjusted gross income after deducting operational expenses for self-employment income.

4. If income is expected to change, flag the case for review at the time of change and recalculate per instructions for change in situation.

REVISED 11/01/07-CHANGE NO. 22-07

For questions or clarification on any of the policy contained in these manuals, please contact your local county office.