Medicaid Policy                                                                 

441-2 Income Eligibility and Calculation for Child Medically Needy

Effective Date: November 1, 2021

Previous Policy (441-2 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.   To determine eligibility for a child on Child Medically Needy, count the income of both the child and the child's parents (See: 415-5 for child support payments; 415-1 for unearned income; 404-5 for income that is excluded for a child.)

a.       If a child meeting the age criteria is emancipated, continue to count the parents' income.

b.       Count income of a child's spouse, if applicable.

c.       Do not count income of a non-parent caretaker.

d.       Do not count income of the child's siblings.  

 

2.    Policy prohibits the deeming of a child's income and assets to a parent.

a.    All children, as applicable, are counted in the household size along with their parent(s).

b.    Any income and assets of a child is not counted for the Medically Needy Pregnant Woman program.

3.    Do not deem of income or assets of a non-parent caretaker relative to the relative child.

4.    If a child lives with a former step-parent, but the step-parent is no longer married to the child's biological or adoptive parent, do not deem income from the step-parent to the child. 

 

B.   Income Calculation for Child 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 Child 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).