621.03 HCBC-ECI Medical Assistance SR 00-07, 02/00 (AAM-A)

Individuals requesting HCBC-ECI medical assistance-only are always considered an assistance group of 1. See Part 231.03, HCBC-ECI Medical Assistance. Do not consider the income or resources of the spouse if they reside together. Use the following steps to determine if the individual is income-eligible as categorically or medically needy.

Determining Income Eligibility as Categorically Needy

• Add the individual’s countable gross earned income to countable gross unearned income.

 Exception: Do not include VA Aid and Attendance or SSI in this step.

• Gross income must be equal to or below the CAP income limit (see Table A).

- If gross income is equal to or below the CAP, the individual is income-eligible for HCBC-ECI services as categorically needy.*

- If gross income exceeds the CAP, determine income eligibility as medically needy.

Determining Income Eligibility as Medically Needy

• Subtract the following from countable gross earned income:

- Employment Expense Disregard (EED) for OAA and ANB individuals, or

- Earned Income Disregard (EID) for APTD individuals.

The result is net earned income.

• Add countable gross unearned income to net earned income.

• Subtract any allowable deductions (See AAM 605, Deductions). The result is net assistance group income.

• Compare net assistance group income to the HCBC medically needy income limit.

- If net income is equal to or below the medically needy income limit in Table B, the individual is income eligible for HCBC-ECI services as medically needy. DEAS staff will determine the individual’s cost of care obligation.

- If net income exceeds the income limit, deny the application for HCBC-ECI services. See Part 625, In and Out Medical Assistance, to determine potential In and Out eligibility.