Medicaid Policy                                                                 

431-16 Community Transitions and Limited Supports Waiver Deductions

Effective Date: November 1, 2021

Previous Policy (431-16 was previously found in section 409-18 until November 1, 2021)

 

A.   Post-Eligibility Deductions for the Community Transitions and Limited Supports Waivers 

Members eligible for the Community Transitions and Limited Supports Waiver receive certain deductions from income to decide what their cost of care will be. Deductions for post-eligibility are taken out of "Total Income." (463-1) Total income includes income that may be disregarded to determine eligibility for non-waiver programs. See Sec. 403-4 for total income included in the post-eligibility process.

Use the following for all other income categories:

 

B.  Community Groups and Spenddown Waiver Group

Members in the SSI Recipient, SSI Protected groups, 100% FPL Aged or Disabled groups, MWI group and Spenddown waiver income group do not have a post eligibility test.

·       The MWI income category does not follow a Post Eligibility process, follow the rules found in 314 for the MWI premium.   

 

C.  Special Income Group

1. Total income Does Not Exceed 300% of the SSI Payment Rate.

·       These members are allowed to keep all of their income as a personal needs allowance.  They do not owe a cost of care contribution.

2.   Total income Exceeds 300% of the SSI Payment Rate (Spenddown Waiver Group).

·       These members receive the same deductions allowed for ABD spenddown Medicaid to determine their spenddown.