*** The Health Care Programs Manual (HCPM) has been replaced by the Minnesota Health Care Programs Eligibility Policy Manual (EPM) as of June 1, 2016. Please refer to the EPM for current health care program policy information. ***
Effective: June 1, 2014 |
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Archived: June 1, 2016 (Previous Versions) |
This chapter defines income calculation policy for each health care program. This section provides an overview of the income calculation process, and links to sections with more detailed information.
The certification period must be defined before determining a client’s income eligibility in order to be sure to use the client’s correct income amounts in the income calculation.
The income calculation process begins with determining gross income.
l MinnesotaCare uses the household’s gross income to establish initial and continuing eligibility. The gross income along with other factors, determine the premium amount.
l MA Method A, MA Method B and Medicare Savings Programs (MSP) do not use the gross income to establish eligibility. These programs use the net income to establish initial and ongoing eligibility. The income deductions and disregards vary among different populations. See MA Countable Income Determination for rules on calculating this amount.
Net income is the income remaining after subtracting deductions and disregards from gross income. MA Method A, MA Method B and Medicare Savings Programs each use different rules for applying deductions and disregards in the income calculation.
See the following sections for more information:
l MinnesotaCare Income Calculation.
l MA Method A Income Calculation.
l MA Method B Income Calculation.
l Medicare Savings Programs Income Calculation.
Compare the net income to the appropriate program income standard to determine income eligibility. Income standards for health care programs are based on the Federal Poverty Guidelines (FPG). These guidelines are updated annually by the federal government and are effective in July of each year.
For more information see:
Eligibility Groups and Bases of Eligibility.