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, 2024 to June 30, 2025 |
$767 |
|
July 1, 2023 to June 30, 2024 |
$740 |
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, 2025 to December 31, 2025 |
$3,948.00 |
|
January 1, 2024 to December 31, 2024 |
$3,853.50 |
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, 2024 to June 30, 2025 |
$2,555 |
|
July 1, 2023 to June 30, 2024 |
$2,466 |
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, 2024 to September 30, 2025 |
$649 |
| October 1, 2023 to September 30, 2024 |
$651 |
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, 2024 to September 30, 2025 |
$229 |
|
October 1, 2023 to September 30, 2024 |
$213 |
|
Effective Dates |
Telephone Allowance |
|
October 1, 2024 to September 30, 2025 |
$60 |
|
October 1, 2023 to September 30, 2024 |
$54 |
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, 2025 to December 31, 2025 | $730,000 |
|
January 1, 2024 to December 31, 2024 |
$713,000 |
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, 2024 to December 31, 2024 |
67 cents |
| January 1, 2023 to December 31, 2023 | 65.5 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, 2025 to December 31, 2025 | $128 |
|
January 1, 2024 to December 31, 2024 |
$125 |
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, 2024 to June 30, 2025 |
$1,255 |
|
July 1, 2023 to June 30, 2024 |
$1,215 |
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, 2024 to June 30, 2025 |
$1,295 |
|
July 1, 2023 to June 30, 2024 |
$1,256 |
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, 2025 to December 31, 2025 |
No minimum |
$157,920 |
|
January 1, 2024 to December 31, 2024 |
No minimum |
$154,140 |
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, 2025 to December 31, 2025 |
1.025 |
|
January 1, 2024 to December 31, 2024 |
1.032 |
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 |
| January 1, 2025 to June 30, 2025 |
$281 |
| July 1, 2024 to December 31, 2024 | $278 |
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, 2025 to December 31, 2025 |
$2,901 |
|
January 1, 2024 to December 31, 2024 |
$2,829 |
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, 2024 to June 30, 2025 |
$10,620 |
|
July 1, 2023 to June 30, 2024 |
$9,526 |
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, 2025 to December 31, 2025 |
$2,350 |
$9,460 |
|
January 1, 2024 to December 31, 2024 |
$2,290 |
$9,230 |
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, 2025 to December 31, 2025 |
$967 |
|
January 1, 20234 to December 31, 2024 |
$943 |
|
Effective Date |
Couple |
|
January 1, 2025 to December 31, 2025 |
$1,450 |
|
January 1, 2024 to December 31, 2024 |
$1,415 |
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 |
2023 Tax Year Threshold Amount | 2024 Tax Year Threshold Amount |
|
Single |
No |
No |
Earned Income |
$13,850 | $14,600 |
|
Single |
No |
No |
Unearned Income |
$1,250 | $1,300 |
|
Single |
No |
No |
Gross Income |
Larger of $1,250 or Earned Income Reported up to $13,450 + $400 | Larger of $1,300 or Earned Income Reported up to $14,150 + $450 |
|
Single |
Yes |
No |
Earned Income |
$15,350 | $16,550 |
|
Single |
Yes |
No |
Unearned Income |
$2,750 | $3,250 |
|
Single |
Yes |
No |
Gross Income |
Larger of $2,750 or Earned Income Reported up to $13,450 + $1,900 | Larger of $3,250 or Earned Income Reported up to $14,150 + $2,400 |
|
Single |
No |
Yes |
Earned Income |
$15,350 | $16,550 |
|
Single |
No |
Yes |
Unearned Income |
$2,750 | $3,250 |
|
Single |
No |
Yes |
Gross Income |
Larger of $2,750 or Earned Income Reported up to $13,450 + $1,900 | Larger of $3,250 or Earned Income Reported up to $14,150 + $2,400 |
|
Single |
Yes |
Yes |
Earned Income |
$16,850 | $18,500 |
|
Single |
Yes |
Yes |
Unearned Income |
$4,250 | $5,200 |
|
Single |
Yes |
Yes |
Gross Income |
Larger of $4,250 or Earned Income Reported up to $13,450 + $3,400 | Larger of $5,200 or Earned Income Reported up to $14,150 + $4,350 |
|
Married |
No |
No |
Earned Income |
$13,850 | $14,600 |
|
Married |
No |
No |
Unearned Income |
$1,250 | $1,300 |
|
Married |
No |
No |
Gross Income |
Larger of $1,250 or Earned Income Reported up to $13,450 + $400 | Larger of $1,300 or Earned Income Reported up to $14,150 + $450 |
|
Married |
Yes |
No |
Earned Income |
$15,700 | $16,150 |
|
Married |
Yes |
No |
Unearned Income |
$3,100 | $2,850 |
|
Married |
Yes |
No |
Gross Income |
Larger of $3,100 or Earned Income Reported up to $13,450 + $2,250 | Larger of $2,850 or Earned Income Reported up to $14,150 + $2,000 |
|
Married |
No |
Yes |
Earned Income |
$15,700 | $16,150 |
|
Married |
No |
Yes |
Unearned Income |
$3,100 | $2,850 |
|
Married |
No |
Yes |
Gross Income |
Larger of $3,100 or Earned Income Reported up to $13,450 + $2,250 | Larger of $2,850 or Earned Income Reported up to $14,150 + $2,000 |
|
Married |
Yes |
Yes |
Earned Income |
$17,550 | $17,700 |
|
Married |
Yes |
Yes |
Unearned Income |
$4,950 | $4,400 |
|
Married |
Yes |
Yes |
Gross Income |
Larger of $4,950 or Earned Income Reported up to $13,450 + $4,100 | Larger of $4,400 or Earned Income Reported up to $14,150 + $3,550 |