Appendix F

Standards and Guidelines

This appendix provides figures used to determine eligibility for a person, or in a specific calculation completed to determine eligibility.

Community Spouse Allowances

The Community Spouse Allowances are used when determining the long-term care (LTC) income calculation’s community spouse allocation.

Basic Shelter Allowance

The Basic Shelter Allowance is used to determine if the community spouse has any excess shelter expenses.

Effective Dates

Basic Shelter Allowance

July 1, 2021 to June 30, 2022

$653

July 1, 2020 to June 30, 2021

$647

Maximum Monthly Income Allowance

The Maximum Monthly Income Allowance, along with the Minimum Monthly Income Allowance, is used to determine the community spouse’s monthly maintenance needs amount.

Effective Dates

Maximum Monthly Income Allowance

January 1, 2021 to December 31, 2021

$3,259.50

January 1, 2020 to December 31, 2020

$3,216

Minimum Monthly Income Allowance

The Minimum Monthly Income Allowance, along with the Maximum Monthly Income Allowance, is used to determine the community spouse’s monthly maintenance needs amount.

Effective Dates

Minimum Monthly Income Allowance

July 1, 2021 to June 30, 2022

$2,178

July 1, 2020 to June 30, 2021

$2,155

Utility Allowance

The Utility Allowance is allowed as a shelter expense if the community spouse is responsible for heating or cooling costs.

Effective Dates

Utility Allowance

October 1, 2020 to September 30, 2021

$496

October 1, 2019 to September 30, 2020

$490

The Electricity and Telephone Allowances are allowed as shelter expenses if the community spouse is not responsible for heating or cooling expenses, but is responsible for electricity or telephone expenses.

Effective Dates

Electricity Allowance

October 1, 2020 to September 30, 2021

$154

October 1, 2019 to September 30, 2020

$143

 

Effective Dates

Telephone Allowance

October 1, 2020 to September 30, 2021

$56

October 1, 2019 to September 30, 2020

$49

Federal Poverty Guidelines

The federal poverty guidelines (FPG) are used to determine income eligibility for the Minnesota Health Care Programs (MHCP).

Refer to Insurance and Affordability Programs (IAPs) Income and Asset Guidelines (DHS-3461A) for the current FPG.

Home Equity Limit

The Home Equity Limit is applied only in specific situations and at certain times.

Effective Dates

Home Equity Limit

January 1, 2021 to December 31, 2021

$603,000

January 1, 2020 to December 31, 2020

$595,000

IRS Mileage Rate

The IRS mileage rate is used in many calculations to determine eligibility or reimbursement costs.

Effective Dates

IRS Mileage Rate

January 1, 2021 to December 31, 2021

56 cents

January 1, 2020 to December 31, 2020

57.5 cents

Long-Term Needs Allowances

The LTC needs allowances provide figures for needs allowances used in the LTC income calculation and for determining the community spouse or family allocation amounts.

Clothing and Personal Needs Allowance

The Clothing and Personal Needs Allowance is used when the enrollee is not eligible for any of the other LTC needs allowances.

Effective Dates

Clothing and Personal Needs Allowance

January 1, 2021 to December 31, 2021

$105

January 1, 2020 to December 31, 2020

$104

Home Maintenance Allowance

The Home Maintenance Allowance can be deducted from a person’s LTC income calculation if certain conditions are met.

Effective Dates

Home Maintenance Allowance

July 1, 2021 to June 30, 2022

$1,074

July 1, 2020 to June 30, 2021

$1,064

Special Income Standard for Elderly Waiver Maintenance Needs Allowance

The Special Income Standard for Elderly Waiver (SIS-EW) maintenance needs allowance is used in the LTC income calculation for persons who have income at or below the Special Income Standard (SIS).

Effective Dates

Maintenance Needs Allowance

July 1, 2021 to June 30, 2022

$1,059

July 1, 2020 to June 30, 2021

$1,038

Maximum Asset Allowance

The Maximum Asset Allowance is used for the community spouse asset allowance for an asset assessment.

Effective Dates

Minimum

Maximum

January 1, 2021 to December 31, 2021

No minimum

$130,380

January 1, 2020 to December 31, 2020

No minimum

$128,640

MinnesotaCare Premium Amounts

MinnesotaCare premiums are calculated using a sliding fee scale based on household size and annual income.

Refer to MinnesotaCare Premium Estimator Table (DHS-4139) for information about MinnesotaCare premiums. The table provides an estimate of the premium before receiving the actual bill. The premium calculated by the system and listed on the bill is the official calculation and the amount to be paid.

Pickle Disregard

The Pickle Disregard is a disregard of the Retirement, Survivors and Disability Insurance (RSDI) cost of living adjustment (COLA) amounts for Medical Assistance (MA) Method B and the Medicare Savings Programs (MSP).

Effective Date

Pickle Disregard

January 1, 2021 to December 31, 2021

1.013

January 1, 2020 to December 31, 2020

1.016

Remedial Care Expense

The Remedial Care Expense deduction amount can be used as a health care expense when meeting a spenddown or as an income deduction in an LTC income calculation.

Effective Dates

Remedial Care Expense

July 1, 2021 to December 31, 2021

$189

January 1, 2021 to June 30, 2021

$177

Roomer and Boarder Standard Amount

The Roomer and Boarder Standard income is used in calculating the amount of self-employment income a person who rents or boards another person has to add to the MA Method A income calculation.

Roomer and Boarder Standard

Amount

Roomer Amount

$71

Boarder Amount

$155

Roomer plus Boarder Amount

$226

Special Income Standard

The Special Income Standard (SIS) is used to determine certain criteria for the Elderly Waiver (EW) Program.

Effective Dates

SIS

January 1, 2021 to December 31, 2021

$2,382

January 1, 2020 to December 31, 2020

$2,349

Statewide Average Payment for Skilled Nursing Facility Care

The statewide average payment for skilled nursing facility (SAPSNF) care amount is used to determine a transfer penalty for MA. The SAPSNF is updated annually in July.

Effective Dates

SAPSNF

July 1, 2021 to June 30, 2022

$8,781

July 1, 2020 to June 30, 2021

$8,412

Student Earned Income Exclusion

The Student Earned Income Exclusion is a disregard of earned income for people who are under age 22 and regularly attending school. It is only available for MA Method B and MSP.

Effective Date

Monthly

Annual

January 1, 2021 to December 31, 2021

$1,930

$7,770

January 1, 2020 to December 31, 2020

$1,900

$7,670

Supplemental Security Income Maximum Payment Amount

These figures are the maximum benefit amounts for people eligible for Supplemental Security Income (SSI). A person’s SSI benefit amount is based on the income of the person and certain responsible household members.

SSI benefit payments may be deducted from the LTC income calculation if the person qualifies for the Special SSI Deduction.

Effective Date

Individual

January 1, 2021 to December 31, 2021

$794

January 1, 2020 to December 31, 2020

$783

 

Effective Date

Couple

January 1, 2021 to December 31, 2021

$1,191

January 1, 2020 to December 31, 2020

$1,175

Tax Filing Income Threshold for Children and Tax Dependents

The tax filing income threshold refers to the income level at which a person must file a federal income tax return. The thresholds for tax dependents determines whether a child's or tax dependent's income is counted or excluded when calculating household income for MA-FCA and MinnesotaCare eligibility.

The income threshold for tax filing varies based on the tax dependent's age and marital status and whether the person is blind. If a child or tax dependent has income at or below these thresholds, his or her income will not count toward the household income for MA-FCA and MinnesotaCare eligibility.

The income threshold applies to the taxable income that a child or tax dependent is expected to receive in the tax year. Nontaxable income, such as Supplemental Security Income (SSI) and veterans benefits, is not included in determining whether a child's or tax dependent's income is at or below the income threshold. Any nontaxable portion of a child's Social Security dependent or survivor benefits is not included.

The income thresholds for children and tax dependents are:

Tax Filing Income Thresholds for Tax Dependents

Marital Status

Age over 65?

Blind?

Income Type

2020 Tax Year Threshold Amount

2021 Tax Year Threshold Amount

Single

No

No

Earned Income

$12,200

$12,400

Single

No

No

Unearned Income

$1,100

$1,100

Single

No

No

Gross Income

Larger of $1,100 or Earned Income Reported up to $11,850 + $350

Larger of $1,100 or Earned Income Reported up to $12,050 + $350

Single

Yes

No

Earned Income

$13,850

$14,050

Single

Yes

No

Unearned Income

$2,750 $2,750

Single

Yes

No

Gross Income

Larger of $2,750 or Earned Income Reported up to $11,850 + $2,000

Larger of $2,750 or Earned Income Reported up to $12,050 + $2,000

Single

No

Yes

Earned Income

$13,850

$14,050

Single

No

Yes

Unearned Income

$2,750 $2,750

Single

No

Yes

Gross Income

Larger of $2,750 or Earned Income Reported up to $11,850 + $2,000

Larger of $2,750 or Earned Income Reported up to $12,050 + $2,000

Single

Yes

Yes

Earned Income

$15,500

$15,700

Single

Yes

Yes

Unearned Income

$4,400

$4,400

Single

Yes

Yes

Gross Income

Larger of $4,400 or Earned Income Reported up to $11,850 + $3,650

Larger of $4,400 or Earned Income Reported up to $12,050 + $3,650

Married

No

No

Earned Income

$12,200

$12,400

Married

No

No

Unearned Income

$1,100

$1,100

Married

No

No

Gross Income

Larger of $1,100 or Earned Income Reported up to $11,850 + $350

Larger of $1,100 or Earned Income Reported up to $12,050 + $350

Married

Yes

No

Earned Income

$13,500

$13,700

Married

Yes

No

Unearned Income

$2,400

$2,400

Married

Yes

No

Gross Income

Larger of $2,350 or Earned Income Reported up to $11,650 + $1,650

Larger of $2,400 or Earned Income Reported up to $12,050 + $1,650

Married

No

Yes

Earned Income

$13,300 $13,700

Married

No

Yes

Unearned Income

$2,350

$2,400

Married

No

Yes

Gross Income

Larger of $2,400 or Earned Income Reported up to $11,850 + $1,650

Larger of $2,400 or Earned Income Reported up to $12,050 + $1,650

Married

Yes

Yes

Earned Income

$14,800

$15,000

Married

Yes

Yes

Unearned Income

$3,700

$3,700

Married

Yes

Yes

Gross Income

Larger of $3,700 or Earned Income Reported up to $11,850 + $2,950

Larger of $3,700 or Earned Income Reported up to $12,050 + $2,950