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Revision 09-4; Effective December 1, 2009
A person is eligible for Medicaid if the person:
- is aged, blind or disabled;
- meets the income and resource limits; and
- meets all other requirements for the specific MEPD program.
This chapter covers treatment of income to budget to determine eligibility and, if applicable, co-payment. Treatment of budgets is covered in other chapters.
For purposes of Medicaid, income is anything a person receives in cash or in kind that can be used to meet the person’s needs for food and shelter. It is the receipt of any property or service a person can apply, either directly or by sale or conversion, to meet basic needs for food and shelter. Income is normally counted on a monthly basis; not all income goes into the budget to determine eligibility and the co-payment.
The receipt of a payment – in the form of cash, property, or service – is income in the month of receipt and a resource as of 12:01 a.m. on the first day of the month after receipt.
E-1210 Other Terms
Revision 09-4; Effective December 1, 2009
Calendar quarter — A period of three full calendar months beginning with January, April, July or October.
Child — A person who is not married, is not the head of a household, and is either under age 18 or is under age 22 and a student.
Couple — An eligible individual and his or her eligible spouse.
Supplemental Security Income (SSI) benefit rate — The payment amount in the SSI program.
Federal benefit rate — The monthly payment rate for an eligible individual or couple. It is the figure from which countable income is subtracted to find out how much a person’s federal SSI benefit should be. The federal benefit rate does not include the rate for any state supplement paid by us on behalf of the state.
Shelter — Includes room, rent, mortgage payments, real property taxes, heating fuel, gas, electricity, water, sewerage and garbage collection services. A person is not receiving in-kind support and maintenance in the form of room or rent if the person is paying the amount charged under a business arrangement. A business arrangement exists when the amount of monthly rent required to be paid equals the current market rental value.
Income — The receipt of any property or service a person can apply, either directly or by sale or conversion, to meet basic needs for food and shelter.
Countable income — The amount of a client's income after all exemptions and exclusions.
Income of spouse — Income considered when one member of a couple is institutionalized. Income paid to one spouse is considered to be the income of that spouse, unless a fair hearings process establishes otherwise, or the payor provides evidence that the income is augmented for a spouse, such as VA benefits. Income from community property paid to only one spouse is considered the income of that spouse regardless of state law governing community property or division of marital property. (Consult the regional attorney about ownership of income from a trust.)