Adult Medicaid Manual MA-2311 LIS PROCESSING AND MAINTENANCE

IV. INCOME

Unless otherwise indicated in this section, follow rules for determining availability, exclusions and countable income in MA-2250, Income.

A. Income Limit

In order to be eligible for the LIS, a Medicare beneficiary’s income must be less than 150% of the federal poverty level (FPL). However, there are different levels of subsidy assistance with different income limit ranges between 135% and 150% of the federal poverty level. Refer to the LIS Income Limits Table in IX below.

REVISED 03/01/12 – CHANGE NO. 05-12

(IV)

B. Determine Whose Income is Counted

Count income available to the applicant and the spouse, if living in the home. Do not count income of any dependents who are included in family size.

C. Determine Countable Income

Verify the gross income of the applicant and spouse, if living in the home. Apply the following exclusions, if applicable, to the gross income of the applicant and spouse, if living in the home:

1. Determine countable net unearned income. Apply the following exclusions to gross unearned income, if applicable:

a. One-third of support payments made to or for the applicant by an absent parent if the applicant is a child;

b. The first $20 of any unearned income other than in-kind income or needs-based income;

The remainder is countable net unearned income.

2. Determine countable net earned income. Apply the following exclusions in the order listed:

a. Payments under Earned Income Tax Credit (EITC) and all other Federal and State tax refunds (excluded for 12 calendar months beginning the month of receipt);

b. Any portion of the $20 monthly exclusion which was not excluded from unearned income;

c $65 per month of the applicant/spouse’s earned income;

d. 16.3% of gross earnings for an applicant under 65 for impairment-related work expenses (IRWE);

e. One-half of the applicant/spouse’s remaining earned income; and

f. Twenty-five percent (25%) of gross earnings for an applicant under age 65 who receives disability based on blindness for blind work expenses (BWE).

The remainder is the countable net earned income for the applicant.

3. Combine the net unearned and earned income. This is the countable income for the applicant.

REISSUED 03/01/12 – CHANGE NO. 05-12

(IV)

D. Determine the Family Size and Income Limit

1. Determine the family size. Family size includes:

a. The applicant, and

b. The applicant’s spouse, if living in the home, and

c. Any persons who are related by blood, marriage or adoption, who are living with the applicant and the spouse and are dependent on the applicant or spouse for at least one half their financial support.

2. Compare the net countable income from IV. B.3., above to the income limit for the family size. Refer to the LIS Income Limits Table in IX below.