Effective: December 1, 2006 |
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21.35ar1 - Medicare Savings Programs Income Calculation (Archive) |
Archived: February 1, 2008 |
The purpose of the income calculation is to determine a person’s countable net income. This net income will be compared to the appropriate income standard to determine if the client is income eligible for QMB , SLMB , QI and QWD .
Note: Follow this income calculation regardless if the client is in an LTCF or receiving EW services.
Income calculation steps for the Medicare Savings Programs are:
1. Determine countable gross income.
2. Deduct disregards and deductions in the listed order to arrive at countable net income:
Note: The rules for whom and when a disregard or deduction can be used are found in the section of the same name.
l Unearned Income:
b. Pickle Disregard.
c. Disabled Adult Child Disregard.
d. RSDI Cost of Living Adjustment Disregard.
e. PASS Deduction.
l Earned Income:
a. PASS Deduction.
b. Blind Disabled Student Child Disregard.
c. Standard Deduction remaining after use for unearned income.
d. $65 Earned Income Disregard.
e. Work Expense for disabled basis of eligibility.
f. One-half of remaining earned income.
g. Work Expense for blind basis of eligibility.
h. LTC/EW only: Spousal Allocation.
i. LTC/EW only: Family Member Allocation.
3. Compare the appropriate income standard to the net income to determine if the client is income eligible.
l If the client’s income is at or below the income standard the client is income eligible.
l If the client’s net income exceeds the income standard the client is not eligible for the program.