DHHS - Medicaid Policy Manual
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  Medicaid Policy                                                                 

 

431-12 Community Supports and Medically Complex Children Waiver Deductions

Effective Date: November 1, 2021

Previous Policy (431-12 was previously found in section 409-14 until November 1, 2021)

 

Deduct these amounts in the following order from the member’s total income.   

  1. Earned income deduction:  The earned income deduction is the SSI Substantial Gainful Activity amount (SGA).  Table II shows these amounts for a disabled or blind member.  Subtract the earned income deduction from the member’s total earned income (431-4).  Add remaining earned income to the member’s total unearned income.

  2. Personal Needs Allowance (PNA):  The PNA is an amount equal to 100% of the FPL .  (Table II)

  3. Spousal Needs Allowance (SNA):  The SNA is described in 431-9.

  4. Dependent Family Member Allowance:  This allowance is described in 431-10.

  5. Health Insurance Premiums:  The deduction of health insurance premiums is described in 431-1.3.

  6. Medical Bills:  The deduction of the member’s medical bills is described in 463-3.

The income remaining after these deductions is the member's contribution to cost of care (463-1).  The member must pay the contribution to cost of care to the DWS central business office before receiving Medicaid eligibility.