*** The Health Care Programs Manual (HCPM) has been replaced by the Minnesota Health Care Programs Eligibility Policy Manual (EPM) as of June 1, 2016.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: May 1, 2012 |
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21.10 - MinnesotaCare Gross Income Determination |
Archived: June 1, 2016 (Previous Versions) |
MinnesotaCare uses gross income to determine income eligibility and premium amounts. This section provides rules for determining the MinnesotaCare annual gross household income.
Follow these steps to determine the annual gross income for a MinnesotaCare household.
Note: Use the MinnesotaCare Income Worksheet (DHS-3352) to help calculate income. Include dollars and cents to compute the annual gross household income. The DHS-3352 will truncate the end result.
1. Determine whose income must be counted as part of the MinnesotaCare household. See Deeming of Assets and Income and Household Composition.
2. Determine if any income is unavailable or excluded. Do not count unavailable or excluded income in the household's gross income.
3. Determine if appropriate verification of income has been received.
4. Determine annual self-employment income for self-employed clients by following the instructions in MinnesotaCare Self-Employment Income.
5. Determine the annual gross earned income for non-self-employed clients.
Calculate annual income based on verifications provided by the client or obtained through an electronic data source.
Note: For information on verifying wage income, see Verification of Income.
For information on calculating seasonal wage income, see Seasonal Income.
6. Determine the annual gross .
n For people receiving Unemployment Insurance (UI), annualize the UI amount to determine eligibility and premium amount, regardless of when the UI is scheduled to end.
n Some people may work and receive a partial UI payment. In these situations, the UI payment will be reduced by a percentage of income based on the amount the client earns at the job. Count the amount of UI received after the reduction as the client's gross UI payment.
For information on verifying unearned income, see Verification of Income.
7. Add the annual gross wage income, unearned income and self-employment income to arrive at the annual gross household income.
8. Compare the appropriate income standard to the annual gross household income to determine if the client is income eligible.
n If the client’s income is at or below the income standard, the client is income eligible.
n If the client’s income exceeds the income standard at:
m Application - the client is ineligible.
m Renewal, or any other time besides application - see MinnesotaCare Excess Income.
9. MMIS will calculate the premium based on the average monthly household income.
Do not anticipate future income changes. Do not verify income changes reported between renewals, but act on changes that are reported.
Example:
Loren applies for MinnesotaCare in March. He is employed full-time but expects to take a leave of absence from May 1 until August 1, during which he will receive no pay. He expects to resume his employment on August 1.
Action:
Calculate annual income based on the verifications provided or obtained electronically. When Loren reports that he has taken a leave of absence, act on that change and recalculate household income. Finally, act on his income change and recalculate household income when he reports that he is back to work. Do not require verification of these income changes between renewals.
Example:
Mr. A reports has been unemployed for several years, but not receiving UI. He just started a job working 30 hours per week at $6 per hour. He will be paid biweekly.
Action:
Base his annual income on the projected wage information he provided. His annual countable income is 60 X $6 = $360 per paycheck. $360 X 26 paychecks = $9,360.
Example:
Jen applies for MinnesotaCare in April, while she is on maternity leave from her job. She currently has no income. She expects to return to work in the third week of June and receive her first weekly $400 pay check at the end of that week.
Action:
Calculate Jen's annual income using $0 income. Recalculate Jen’s income when she reports that she has returned to work.