Table A: Income Limits SR 23-01 Dated 01/23

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

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

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

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

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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

$928

$1,372

$1,817

       (PIL)

       $591

       $675

       $683

Residential Care Facility

 1

 $1,108

Community Residence

• Subsidized

• Unsubsidized

• Enhanced Family Care

1

1

1

$990

$1,050

$1,108

       $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

$2,742

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.