Medical Assistance for People Who Are Age 65 or Older or People Who Are Blind or Have a Disability

2.3.3.3.2.4 Income Verification

Verification of current income is required at application, renewal and when an income change is reported and must occur before an income eligibility determination is made:

At Application: All countable and excluded income must be verified.
At Renewal: All countable income must be verified. Agencies must not re-verify excluded income at renewal.
Between Renewals: Any reported change to existing countable income sources must be verified and any new income source (countable or excluded) reported by an enrollee must be verified. Agencies must not re-verify a change to a previously verified excluded income source between renewals.

Electronic Verification of Income

The agency must attempt to electronically verify attested income before paper proofs may be requested from an applicant or enrollee. The following reliable electronic data sources must be used to verify attested income:

The Work Number (TWN) to verify earned income from employment.
The State Verification and Eligibility System/Third Party Query (SVES/TPQY) to verify Retirement, Survivors, and Disability Insurance (RSDI) benefit amounts, SSI benefit amounts, and railroad benefit amounts.
The Shared Master Index/Social Security Administration State Online Query (SMI/SOLQ) to verify RSDI and SSI benefit amounts.

Paper Proof

If income cannot be electronically verified because electronic data sources are unavailable for a particular type of income, electronic sources return data that indicates income is above the income limit, or if the electronic sources do not return any results, paper proof from an applicant or enrollee must be requested to verify income. Common proof to verify earned and unearned income includes, but is not limited to, the following:

Pay stubs
Employer’s statement
Award letters
Court orders
Copies of checks for unearned income

Paper proofs to verify earnings from self-employment include, but are not limited to:

Tax forms
Business records
Accounting records
Statements from an outside accountant
Ledger books or bookkeeping records

Paper proof(s) submitted by an applicant or enrollee to verify income must be the most recent paper proof available to the applicant or enrollee. County and tribal servicing agencies must assist applicants and enrollees to identify and obtain paper proof(s) that demonstrate current income.

Self-attestation of income may be accepted if electronic data sources are unsuccessful or unavailable and paper proof does not exist or is not available. See EPM 2.3.1.1 MA-ABD Mandatory Verifications.

If paper proofs submitted to verify income show an amount different from what the applicant or enrollee reported, the dollar value reflected by the paper proof must be used to determine income eligibility. If the applicant or enrollee is above the income limit, before denying eligibility for an applicant or closing eligibility for an enrollee, county and tribal servicing agencies must review the case to determine if the person is eligible for:

MA-ABD with a spenddown,
MA for Employed Persons with Disabilities (MA-EPD), or
Any other MHCP basis of eligibility.

Verification of job loss or termination of income is not required unless the enrollee is an MA-EPD enrollee applying for the job loss extension. See EPM 2.3.5.1.3 MA-EPD Work Requirements. Job loss or termination of income is a change in circumstances and must be redetermined based on the reported change. See EPM 1.3.2.1 Change in Circumstances.

Income verified by other public programs (SNAP, MFIP, or Tribal TANF)

When an applicant or enrollee is enrolled in the Supplemental Nutrition Assistance Program (SNAP), Minnesota Family Investment Program (MFIP), or Tribal Temporary Assistance for Needy Families (TANF), county and tribal servicing agencies must use income already verified for any of these programs when processing applications and renewals if all of the following apply:

One or more of the reported sources of income cannot be verified electronically, and the applicant or enrollee did not submit paper proof of that income with the application or renewal form.
- If the applicant or enrollee provided paper proof for any source of income with their application or renewal form, it must be used.

An applicant or enrollee receives SNAP, MFIP or Tribal TANF, and the income used to determine eligibility for the program(s) shows a status of verified on the case.
The applicant or enrollee reported the same source(s) of income (i.e., the same job, same self-employment, etc.) on the application or renewal form as was already verified for SNAP, MFIP or Tribal TANF within the past six months.
The income amount(s) verified for SNAP, MFIP or Tribal TANF results in the applicant or enrollee’s total countable income at or below the applicable income limit.

Income Verification for Retroactive Coverage

Income and assets are considered verified for the retroactive months if all of the following are met:

An applicant reports that their income and assets are below the income and asset limits in the application month.
The applicant reports that their income and asset values were the same in the retroactive months requested as in the application month.
Income for the application month is verified electronically or with paper proof.
Assets for the application month are verified electronically or with paper proof.
- The Asset Verification Service (AVS) will provide results for retroactive months. AVS results for retroactive months should not be used unless the results indicate the applicant or enrollee is above the asset limit. In such cases, the county and tribal servicing agency must follow-up with the applicant on the inconsistency before determining eligibility.

If the applicant attests that income and asset values were not the same in the retroactive months, verification of actual income for each retroactive month requested is required.

These income verification for retroactive coverage policies do not apply to people who request MA for Long-Term Care Services (MA-LTC) and who use a long-term care (LTC) income calculation to determine their LTC spenddown or waiver obligation. These people must have income verified electronically or with paper proof(s) in each month for which retroactive coverage is requested. See EPM 2.4.2.5 for more information.

Legal Citations

Code of Federal Regulations, title 42, section 435.945

Code of Federal Regulations, title 42, section 435.948

Code of Federal Regulations, title 42, section 435.952

Minnesota Rules, part 9505.0095