This is an archived document and does not contain the most current information for this topic. Use this document for reference only.
Appendix F
Standards and Guidelines (Archive)
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, 2016, to June 30, 2017 |
$602 |
|
July 1, 2015, to June 30, 2016 |
$598 |
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, 2016, to December 31, 2016 |
$2,980.50 |
|
January 1, 2015, to December 31, 2015 |
$2,980.50 |
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, 2016 – June 30, 2017 |
$2,005 |
|
July 1, 2015 – June 30, 2016 |
$1,992 |
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, 2016 – September 30, 2017 |
$532 |
|
October 1, 2015 – September 30, 2016 |
$454 |
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, 2016 – September 30, 2017 |
$141 |
|
October 1, 2015 – September 30, 2016 |
$141 |
|
Effective Dates |
Telephone Allowance |
|
October 1, 2016 – September 30, 2017 |
$38 |
|
October 1, 2015 – September 30, 2016 |
$38 |
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, 2016, to December 31, 2016 |
$552,000 |
|
January 1, 2015, to December 31, 2015 |
$552,000 |
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, 2016, to December 31, 2016 |
54 cents |
|
January 1, 2015, to December 31, 2015 |
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, 2016, to December 31, 2016 |
$97 |
|
January 1, 2015, to December 31, 2015 |
$97 |
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, 2016, to June 30, 2017 |
$990 |
|
July 1, 2015, to June 30, 2016 |
$981 |
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, 2016, to June 30, 2017 |
$988 |
|
July 1, 2015, to June 30, 2016 |
$988 |
Minimum and Maximum Asset Allowances
The Minimum and Maximum Asset Allowances are used to determine the community spouse asset allowance for an asset assessment.
|
Effective Dates |
Minimum |
Maximum |
|
January 1, 2016, to December 31, 2016 |
$33,851 |
$119,220 |
|
January 1, 2015, to December 31, 2015 |
$33,851 |
$119,220 |
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, 2016, to December 31, 2016 |
1 |
|
January 1, 2015, to December 31, 2015 |
1.017 |
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, 2016 – December 31, 2016 |
$196 |
|
January 1, 2016 – June 30, 2016 |
$252 |
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, 2015, to December 31, 2015 |
$2,199 |
|
January 1, 2014, to December 31, 2014 |
$2,163 |
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, 2016, to June 30, 2017 |
$6,280 |
|
July 1, 2015, to June 30, 2016 |
$6,141 |
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, 2016, to December 31, 2016 |
$1,780 |
$7,180 |
|
January 1, 2015, to December 31, 2015 |
$1,780 |
$7,180 |
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, 2016, to December 31, 2016 |
$733 |
|
January 1, 2015, to December 31, 2015 |
$733 |
|
Effective Date |
Couple |
|
January 1, 2016, to December 31, 2016 |
$1,100 |
|
January 1, 2015, to December 31, 2015 |
$1,100 |