Table A: Income Limits SR 22-01 Dated 01/22  (AAM-A)

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Exceptions:

Some CFI & HCBS individuals, see Table B, Special Income Limits for CFI and HCBS Individuals;

QMB, see Table C, Qualified Medicare Beneficiary (QMB);

SLMB and SLMB135, see Table D, Specified Low-Income Medicare Beneficiary (SLMB) and SLMB135;

QQDWI, see Table E, Qualified Disabled and Working Individual (QDWI); and

MEAD, see Table F, Medicaid for Employed Adults with Disabilities (MEAD).

 

Living Arrangement

Assistance

Group Size

Financial

Assistance

Categorically

Needy MA

Medically

Needy MA

 

Independent Living

individual

& spouse or needy

       essential person

couple and needy

       essential person

 

1

2

3

 

 

$855

$1,262

$1,670

       (PIL)

       $591

       $675

       $683

 

 

Residential Care Facility

 

 

 

 

 

Community Residence

Subsidized

Unsubsidized

Enhanced Family Care

 

1

1

1

 

 

$917

$977

$1,035

      

       $591

       $591

       $591

 

Nursing Facility

The facility must be licensed and certified for the individual to be entitled to these income limits.

Individuals residing in licensed but uncertified facilities are treated as independent living

1

N/A

$2,523

Gross monthly income must be less than or equal to the "CAP" limit listed here.

Net income must be equal to or less than the monthly Medicaid rate for the nursing facility. See BEAS' Appendix A of the Medicaid Manual, "Nursing Facility Rates."

Compare net income to the PIL for In and Out MA if net income is over the rate of the facility.

 

 

References: He-W 601.06(s), He-W 648.04, He-W 658.03He-W 858.04, He-W 858.05, RSA 151:2,I(e), RSA 167:3-c,I-II, RSA 167:7,I - I-a, RSA 167:27-c, 20 CFR 416.405, 20 CFR 416.2095-416.2099, 42 CFR 435.622, 42 USC 1382g