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Appendix XXXVIII, Pickle Disregard Computation Worksheet
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- Appendix XXXVIII, Pickle Disregard Computation Worksheet
Medicaid for the Elderly and People with Disabilities Handbook
- Chapter A, General Information and MEPD Groups
- Chapter B, Applications and Redeterminations
- Chapter C, Rights and Responsibilities
- Chapter D, Non-Financial
- Chapter E, General Income
- Chapter F, Resources
- Chapter G, Eligibility Budgets
- Chapter H, Co-Payment
- Chapter I, Transfer of Assets
- Chapter J, Spousal Impoverishment
- Chapter K, Reserved for Future Use
- Chapter L, Reserved for Future Use
- Chapter M, Medicaid Buy-In Program
- Chapter N, Medicaid Buy-In for Children
- Chapter O, Waiver Programs, Demonstration Projects and All-Inclusive Care
- Chapter P, Long-term Care Partnership (LTCP) Program
- Chapter Q, Medicare Savings Program
- Chapter R, Case Disposition
- Glossary
- Appendices
- Appendix I, MAO Action Codes
- Appendix II, Forms H1000-A and H1000-B Instructions; Supplement No. 2 Error Messages
- Appendix III, Code Card for Forms H1000-A/B (Categories 1, 3 and 4)
- Appendix IV, Data Broker
- Appendix V, Levels of Evidence of Citizenship and Acceptable Evidence of Identity Reference Guide
- Appendix VI, SSA Claim Number Suffixes
- Appendix VII, County Names, Codes and Regions
- Appendix VIII, Summary of Effects of Institutionalization on Supplemental Security Income (SSI) Eligibility
- Appendix IX, Medicare Savings Program Information
- Appendix X, Life Estate and Remainder Interest Tables
- Appendix XI, Reference for Notification Forms
- Appendix XII, Nursing Facility and Home and Community-Based Services Waiver Information
- Appendix XIII, Reserved for Future Use
- Appendix XIV, In-Kind Support and Maintenance Charts A through E; Worksheets A through D
- Appendix XV, Notification to Provide Proof of Citizenship and Identity
- Appendix XVI, Documentation and Verification Guide
- Appendix XVII, System Generated IEVS Worksheet Legends for IRS Tax Data
- Appendix XVIII, IRS Tax Code, Sections 7213, 7213A, and 7431
- Appendix XIX, Reserved for Future Use
- Appendix XX, Deeming Noninstitutional Budgets – Couple Living in the Same Household
- Appendix XXI, Reserved for Future Use
- Appendix XXII, Home and Community-Based Services Waiver Program Co-Payment Worksheets
- Appendix XXIII, Procedure for Designated Vendor Number to Withhold Vendor Payment
- Appendix XXIV, Reserved for Future Use
- Appendix XXV, Accessibility to Income and Resources in Joint Bank Accounts
- Appendix XXVI, ICF/ID Vendor Payment Budget Worksheets
- Appendix XXVII, Worksheet for Expanded SPRA on Appeal
- Appendix XXVIII, Worksheet for Spouse's Income (Post-Expanded SPRA Appeals)
- Appendix XXIX, Special Deeming Eligibility Test for Spouse to Spouse
- Appendix XXX, Medical Effective Dates (MEDs)
- Appendix XXXI, Budget Reference Chart
- Appendix XXXII, Reserved for Future Use
- Appendix XXXIII, Medicaid for the Elderly and People with Disabilities Information
- Appendix XXXIV, Burial Resources
- Appendix XXXV, Treatment of Insurance Dividends
- Appendix XXXVI, Qualified Income Trusts (QITs) and Medicaid for the Elderly and People with Disabilities (MEPD) Information
- Appendix XXXVII, Master Pooled Trust and Medicaid Eligibility Information
- Appendix XXXVIII, Pickle Disregard Computation Worksheet
- Appendix XXXIX, MBI Screening Tool and Worksheets
- Appendix XL, Medicare and Extra Help Information
- Appendix XLI, Reserved for Future Use
- Appendix XLII, Variable Income Worksheet
- Appendix XLIV, Reserved for Future Use
- Appendix XLV, Program Transfer with Form H1200 Guide
- Appendix XLVI, Reserved for Future Use
- Appendix XLVII, Simplified Redetermination Process
- Appendix XLVIII, Medicaid Buy-In for Children (MBIC) Denial Codes
- Appendix XLIX, Medicaid Buy-In for Children Program Forms Chart
- Appendix L, 2020 Income/Resources Reference Chart
- Appendix LI, Self-Service Portal (SSP) Information
- Appendix LII, Reserved for Future Use
- Appendix LIII, Sponsor to Alien Deeming Worksheet
- Appendix LIV, Description of Alien Resident Cards
- Appendix LV, Reserved for Future Use
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Revision 20-1; Effective March 1, 2020
Note: This information is effective Jan. 1, 2020.
Appendix is available for staff use, here.