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All Medicaid Programs |
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Obsolete Policy |
Effective Date: March 1, 2013 - September 30, 2013
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Aged, Blind or Disabled Spenddown Level
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Household Size |
100% of Poverty
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1 2 |
$ 958 $1,293 |
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Other Important Figures |
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SSI Related Amounts (Effective January 1, 2013 |
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Monthly SSI Benefit Payments (maximum) SSI Rate for an Individual |
$710 |
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SSI Rate for an eligible Couple |
$1,066 |
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300% of SSI Rate |
$2,130 |
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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 |
$355 |
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Allocation for Parents (ABD Deeming) |
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1 parent in home |
$710 |
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2 parents in home |
$1,066 |
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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 |
$256.66 |
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PMV for a couple |
$375.33 |
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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 $1,730 $6,960 |
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1619b Income Limit |
$2794.00/month |
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SSI Break-Even Point (earned income only) |
$1,505 |
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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) |
$1040/month |
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Substantial Gainful Activity Level (blind) |
$1,740/month |
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Earnings Required for a Quarter of Coverage |
$1,160 |
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Medicare Related Figures |
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Medicare Part B Premium Amount |
$104.90 |
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Part B Annual Deductible |
$147 |
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Medicare Part A Deductible |
$1,184 |
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Skilled Nursing Home Co-Insurance (days 21-100) |
$148.00/day |
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Asset Limits for Medicare Cost-Sharing Programs (Effective January 1, 2013) |
Single Individual Married Couple |
$7,080 $10,620 |
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Part D Low-Income Subsidy Premium Allowance |
$42.10 |
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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, 2012 through June 30, 2013) |
$1,891.25 |
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Maximum Spousal Needs Standard (Effective January 1, 2013) |
$2,898.00 |
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Shelter Standard (for Spousal Needs Allowance Calculation) (Effective July 1, 2012 through June 30, 2013) |
$567.38 |
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Standard Utility Allowance (for Spousal Needs Allowance Calculation effective October 1, 2012) |
$287.00 |
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Home Equity Limits (Effective January 1, 2013) |
Maximum $536,000.00 |
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Assessment of Assets Limits |
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Minimum Spousal Asset Share (Effective January 1, 2013) |
$ 23,184.00 |
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Maximum Spousal Asset Share (Effective January 1, 2013) |
$115,920.00 |
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Institutional Personal Needs Allowance (PNA) (Effective January 1, 2009 - December 31, 2012) |
$ 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, 2013) |
$ 958.00 |
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Physical Disabilities Waiver Income Eligibility Limit: 300% SSI rate (Effective January 1, 2013) |
$2,130.00 |
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PDW PNA = all income when total income does not exceed 300% of SSI. (Effective January 1, 2013) PDW PNA = 100% of FPL for 1 when income exceeds 300% of SSI. Must spend down. (Effective March 1, 2013) |
up to $2,130
$ 958.00 |
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New Choices Waiver Special Income Group Income Eligibility Limit (300% of SSI Rate) (Effective January 1, 2013) |
$2,130.00 |
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NCW Special Income Group Personal Needs Allowance. 100% of poverty. (Effective March 1, 2013) |
$958.00 |
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Waiver Shelter (Actual Rent, or Mortgage/Taxes/Insurance) Deductions: Utility Allowance with heating or cooling expense
For allowable waivers (Effective October 1, 2012) |
up to $300.00
$287.00 |
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Non-Heat/Cool Utility Allowance For allowable waivers (Effective October 1, 2012 ) |
$204.00 |
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Telephone Only Allowance for allowable waivers |
$29.00 |
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Institutional/Waiver Earned Income Deductions |
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Aging, Brain Injury, and New Choices Special Income Group Waiver |
$ 125.00 |
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UCSW, Technology Dependent and Autism Disabled (SGA) (Effective January 1, 2013) |
$1,040.00 |
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UCSW, Technology Dependent and Autism Blind (SGA) (Effective January 1, 2013) |
$1,740.00 |
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Institutional |
$ 125.00 |
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