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All Medicaid Programs |
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Obsolete Policy |
End Date: December 31, 2011
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Aged, Blind or Disabled Spenddown Level Effective March 1, 2011 |
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Household Size |
100% of Poverty
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1 2 |
$ 908 $1,226 |
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Other Important Figures |
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SSI Related Amounts (Effective January 1, 2009 |
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Monthly SSI Benefit Payments (maximum) SSI Rate for an Individual |
$674 |
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SSI Rate for an eligible Couple |
$1,011 |
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300% of SSI Rate |
$2,022 |
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State Supplemental Payment |
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Single lives w/others |
$3.13 |
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Single lives alone |
$0.00 |
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Couple (both on SSI) lives w/others |
$9.73 |
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Couple (both on SSI) lives alone |
$4.60 |
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ABD Asset Limits |
Single Person Married Couple |
$2,000 $3,000 |
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Income Deeming Amounts |
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Maximum Allocation for Spouse and Deduction for Non-Disabled Children |
$337 |
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Allocation for Parents (ABD Deeming) |
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1 parent in home |
$674 |
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2 parents in home |
$1,011 |
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Unearned Income In-kind in the form of food or shelter |
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PMV (Presumed Maximum Value for Food and Shelter) |
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PMV for one person |
$244.66 |
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PMV for a couple |
$357 |
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Earned Income Deduction for Disabled Student Child and Ineligible Student Child for Deeming Monthly Deduction Maximum Deduction during the Calendar Year |
Up to $1,640 $6,600 |
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1619b Income Limit |
$2,431/month |
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SSI Break-Even Point (earned income only) |
$1,433 |
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Social Security Earned Income Related Figures. (SGA used for disability decision. Covered Quarters is to receive insured status for Social Security and Medicare benefits.) Substantial Gainful Activity Level (non-blind) |
$1000/month |
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Substantial Gainful Activity Level (blind) |
$1,640/month |
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Earnings Required for a Quarter of Coverage |
$1,120 |
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Medicare Related Figures |
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Medicare Part B Premium Amount |
$96.40 or $115.50/month |
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Part B Annual Deductible |
$162 |
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Medicare Part A Deductible |
$1,132 |
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Skilled Nursing Home Co-Insurance (days 21-100) |
$141.50/day |
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Asset Limits for Medicare Cost-Sharing Programs (Effective January 1, 2010) |
Single Individual Married Couple |
$6680 $10,020 |
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Part D Low-Income Subsidy Premium Allowance |
$40.68 |
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PCN Enrollment Fee |
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Applicants, recipients with income equal to or over 50% FPL |
$50 |
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Applicants/recipients with income under 50% FPL |
$25 |
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GA Recipients |
$15 |
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Institutional and Waiver Amounts for Spousal Resources, Income and Shelter Allowances (Effective dates vary) |
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Minimum Spousal Needs Standard (Effective July 1, 2011) |
$1,839.00 |
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Maximum Spousal Needs Standard (Effective January 1, 2009) |
$2,739.00 |
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Shelter Standard (for Spousal Needs Allowance Calculation) (Effective July 1, 2011) |
$552.00 |
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Standard Utility Allowance (for Spousal Needs Allowance Calculation effective October 1, 2011) |
$289.00 |
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Assessment of Assets Limits |
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Minimum Spousal Asset Share (Effective January 1, 2009 - December 31, 2010) |
$ 21,912.00 |
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Maximum Spousal Asset Share (Effective January 1, 2009 - December 31, 2010) |
$109,560.00 |
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Institutional Personal Needs Allowance (PNA) (Effective January 1, 2009 - December 31, 2010) |
$ 45.00 |
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Average Private-Pay Rate for Nursing Homes (used to calculate penalty period for asset transfers) (Effective June 1, 2006) |
$4,526.00 |
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HCB Waivers (except PDW and NCW) Personal Need Allowance. 100% of Poverty (Effective March 1, 2009) |
$ 903.00 |
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Physical Disabilities Waiver Income Eligibility Limit: 300% SSI rate (Effective January 1, 2009 - December 31, 2010) |
$2,022.00 |
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PDW PNA = all income when total income does not exceed 300% of SSI. (Effective January 1, 2009 - December 31, 2010) PDW PNA = 100% of FPL for 1 when income exceeds 300% of SSI. Must spend down. (Effective March 1, 2009) |
up to $2,022
$ 903.00 |
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New Choices Waiver Special Income Group Income Eligibility Limit (300% of SSI Rate) (Effective January 1, 2009 - December 31, 2010) |
$2,022.00 |
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NCW Special Income Group Personal Needs Allowance. 100% of poverty. (Effective March 1, 2009) |
$903.00 |
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Waiver Shelter Deductions: Actual Rent, or Mortgage/Taxes/Insurance for New Choices Special Income Group, Aging and Brain Injury Waivers Utility Allowance with heating or cooling expense 1) for New Choices (Effective October 1, 2011) 2) for Aging and Brain Injury (Effective April 1, 2004) |
up to $300.00
1) $289.00 2) $158.00 |
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Non-Heat/Cool Utility Allowance 1) for New Choices (Effective October 1, 2011) 2) for Aging and Brain Injury (Effective April 1, 2004) |
1) $207.00 2) $79.00 |
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Telephone Only Allowance for New Choices (effective July 1, 2008) |
$28.00 |
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Institutional/Waiver Earned Income Deductions |
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Aging, Technology Dependent, Brain Injury, and New Choices Special Income Group Waiver |
$ 125.00 |
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UCSW Disabled (SGA) (Effective January 1, 2010) |
$1,000.00 |
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UCSW Blind (SGA) (Effective January 1, 2009) |
$1,640.00 |
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Institutional |
$ 125.00 |
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