624.03 HCBC-ABD Medical Assistance SR 99-29, 07/99 (AAM-A)

Use the following steps to determine if the individual is income-eligible as categorically needy or medically needy.

Determining Income Eligibility as Categorically Needy

1. Add countable gross earned income to countable gross unearned income. The result is gross income.

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

2. Compare the result obtained in Step 1 to the "CAP" income limit (See Table B, Income Limits for HCBC Individuals). If gross income is at or below the "CAP" income limit, consider the individual to be categorically needy for HCBC-ABD medical assistance and determine the individual’s cost of care (See Section 624.05).

Determining Income Eligibility as Medically Needy

If the individual is not categorically needy, determine eligibility as medically needy:

1. Subtract the following from the gross earned income amount determined above:

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

- Earned Income Disregard (EID) for APTD individuals.

 The result is net earned income.

2. Add countable gross unearned income to net earned income. *

 Exception: Do not add the VA Aid and Attendance Allowance or SSI in this step.

3. Subtract any allowable deductions. See Part 605, Deductions. The result is net case income.

 Exception: Do not allow allocated income as a deduction in this step.

4. Compare net income to the monthly cost of HCBC-ABD services. See Form 517-B, Area Agency Information Release to DHS District Office.

- If net income is below the cost of HCBC-ABD services, determine the individual’s cost of care. See Section 624.05, Cost of Care: HCBC-ABD Medical Assistance.

- If net income is exceeds the cost of HCBC-ABD services, see Part 625, In and Out Medical Assistance, to determine potential In and Out eligibility.