Family and Children's Medicaid MA-3300 Income

IV. BASE PERIOD FOR MPW APPLICATIONS

A. Definition of Base Period

The base period for computing countable income is the calendar month prior to the month of application. Also use this base period to establish budget unit membership.

Child support, self-employment income, dividends, and income of school employees are calculated using a different base period. See VIII. for the appropriate base period for these types of income.

Always use the actual income from the base period. Do not convert. Round to the nearest whole cent.

1. If the actual base period income is equal to or less than 185% of the Poverty Income Level the pregnant woman is financially eligible from the month of application through the postpartum period.

2. Changes in income do not affect MPW eligibility through the postpartum period. The a/r is not required to report changes. If the recipient reports a change, document the record.

3. If the budget unit’s income exceeds the income level for the base period month, and the income is not expected to decrease, deny eligibility for MPW. Evaluate and document eligibility for MAF Medically Needy.

REISSUED 10/01/11 - CHANGE NO. 13-11

(IV.A.)

4. If the income exceeds the income level for the base period, but the income is expected to decrease or terminate during the application processing time, move the base period to the next calendar month, the month of application.

a. If income is equal to or less than the income level, authorize effective the month of application.

b. If income exceeds the income level in the month of application, but it is verified that income has terminated or decreased and will be less than the income level in the month after application, authorize effective the month after application.

a. Do not hold the application beyond the 45th day waiting for income to decrease.

5. If the a/r is unable to provide income verification for the base period month but does provide income verification for any month after the base period month through the postpartum period, authorize assistance beginning with that month and through the postpartum period if:

a. The countable income is equal to or less than the income level, and

b. All other eligibility requirements are met.

6. Base Period For Retroactive Coverage Only

The base period for computing countable income for the retroactive period is the actual income for the first calendar month of medical need. Also use this base period to establish budget unit membership.

a. If the countable income is equal to or less than the income level for the first month of medical need, the pregnant woman is financially eligible for all months of retroactive need and through the postpartum period. If all other eligibility requirements are met, authorize assistance from the first month of medical need.

b. If the countable income exceeds the income level for the first month of medical need:

(1) Move the base period to the next calendar month(s) of retroactive medical need. If the countable income exceeds the income level for that month, move the base period to the next calendar month of retroactive need. The base period can never go beyond the last month of retroactive coverage.

REVISED 10/01/11 - CHANGE NO. 13-11

(IV.A.6.b.)

(2) When financial eligibility is established and all other eligibility requirements are met, authorize assistance beginning with the month all eligibility requirements are met. Assistance can never begin earlier than the month the income is equal to or below the income level.

(3) If the budget unit’s verified income exceeds the income level for the entire retroactive period, evaluate eligibility for MAF-MN. Follow procedures in IV.A. for prospective coverage.

7. Base Period for Retroactive and Ongoing Coverage

a. Follow the procedures in 6. above for retroactive coverage.

b. If the applicant is eligible in the retroactive period, authorize her through the postpartum period.

c. If the applicant is ineligible in the retroactive period, evaluate for MAF Medically Needy for retroactive coverage.

d. Follow the procedures in 1. through 5. above to determine eligibility for ongoing coverage.

B. Authorization

When financial eligibility is established and all other eligibility requirements are met, authorize assistance beginning with the month all eligibility requirements are met. Assistance can never begin earlier than the month the income is equal to or below the income level.