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All Medicaid Programs |
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Obsolete Policy |
Some payments or benefits an individual receives are not income and therefore are never counted as part of the client's income to determine eligibility. Payments and benefits that are not income include:
Medical and Social Services, Related Cash and In-Kind Items as follows:
From a governmental agency that provides medical or social services:
cash for medical or social services is not income (this does not include payments under TANF, VA, BIA or similar income assistance)
in-kind medical or social services items (including food or shelter)
From non-governmental agencies:
cash for medical or social services the client received is not income if the cash does not exceed the expenses already incurred. Excess cash would count as income.
cash for future medical or social services that is restricted for that purpose only is not income
in-kind medical or social services items that are not food or shelter are not income (for ABD Medicaid food and shelter would count as income)
Food or shelter provided while a person is an inpatient in a medical facility is not income
Things that are not medical and social services and count as income even when provided by a medical or social services agency:
Payments for work performed at sheltered workshops are income
Incentive payments to encourage people to use certain facilities or participate in certain medical or social service activities are income if there are no restrictions on the use of the funds and they are not reimbursements for expenses the person incurs
Payments of flat rate insurance like a hospital plan that pays a daily rate to the client for each day in the hospital is income
Personal Services such as mowing the lawn, shopping, baby sitting, housecleaning, or other similar services, which are done sporadically, without the intent to establish a self-employment business, and render nominal amounts of money.
Receipts from the sale, exchange or replacement of resources are not income. The new form of the resource such as the cash received from selling an excluded car is still a resource, and may count as a resource on the first of the month after the exchange or sale is made.
Rebates, refunds, or return of money already paid is not income when received. Rebates do not include a return on an investment, such as dividends on a business interest.
Amounts refunded from taxes already paid.
Credit life or credit disability insurance payments because these payments are made directly to the loan or mortgage company. The value of food or shelter received as a result (i.e., the credit life pays the mortgage while someone is disabled).
Proceeds from a bona fide loan agreement that the individual is expected to repay. However, if the person lending the money receives interest, the interest received is income.
For Educational Loans see 403-7.
Reverse equity mortgages. Reverse equity mortgages are loans to the homeowner. The monies received are not income in the month of receipt. Under reverse equity mortgages, homeowners may borrow money against the value of their home and receive a lump sum payment, or monthly payments for a certain period of time. The mortgage holder will hold a lien on the property until repayment is made. Repayment can be when: 1) the house is sold; 2) the house is turned over to the mortgage holder; or 3) the owners die and repayment is taken from the settlement of the estate.
The proceeds received from a loan become a countable resource in the month following the month of receipt, if retained. This includes the proceeds from a home equity loan or a reverse equity mortgage. If the loan is an educational loan, see Sec. 521-10 for policy on resource exclusion.
Payment of a person's bills by a third party is not income. (For ABD Medicaid, when a third party pays food or shelter costs, it is in-kind income subject to the PMV rule.)
Replacement of income that was lost or stolen.
A payment the individual knows he or she is not due is not income if the client returns the un-cashed check or otherwise repays the money received in error.
Weatherization assistance (i.e., insulation, storm doors or windows, etc.).
Certain non-cash items (other than food or shelter for ABD Medicaid) are not income if the item will become a wholly or partially excluded non-liquid resource the following month. For example, a client in a wheelchair receives a van with a wheelchair lift paid for by donations raised by his church. This is the client's only vehicle and is excluded the month after he receives it.
Certain Employee benefits. Payments made by employers on behalf of employees that are not earnings and are not available to meet food or shelter costs are not income. For example, payments to a retirement plan, medical insurance and FICA taxes paid by the employer.
TPL. Payments from a medical insurance policy are not income to the client if they are paid directly to medical providers or collected by the Office of Recovery Services as a third party liability.
Sale of bodily fluids payments or benefits received from plasma or other bodily fluid donations.