Medicaid Policy                                                                 

441-1 Income Eligibility and Calculation for Family Medically Needy

Effective Date: November 1, 2021

Previous Policy (441-1 was previously found in section 345 C #4 until November 1, 2021)

 

A.   General Rules:

 

Determine the household’s countable income according to the following rules

1.   Identify whom to include in the Medically Needy household (404).

2.    For a parent, or a married couple’s eligibility on Family Medically Needy, count income of both spouses.  

·       If the parents of a dependent child live together but are not married, do not count any income from one parent to the other parent.

3.    Do not count any income or assets of a child to determine a parent's eligibility for the Family Medically Needy program.

 

B.   Income Calculation for Family Medically Needy

 

Use the following method to calculate the countable income.

1.    Subtract the earned income disregards according to the rules in 431-3 from each employed person's countable earned income (441-1). 

2.    Add the household’s countable unearned income (415 and 417).

3.    The countable income is the remaining income after subtracting the allowable deductions (431-3).

4.    Compare the countable income to the BMS (Basic Maintenance Standard) for the household size (Table VII).

a.    If the countable income does not exceed the BMS for the household size, the household is eligible for Family Medically Needy with no spenddown. (This may happen when the household countable income is more than the BMS, but deductions like health insurance premiums reduce the income to below the BMS.)

b.    If the countable income exceeds the BMS for the household size, the household may spenddown (461).

c.    Subtract the BMS for the household size from the countable income to determine the spenddown (461).