611.01 Computing Eligibility SR 99-03, 02/99 (FAM-A)

Use the following steps to compute income for assistance groups requesting financial or medical assistance:

TANF Financial Assistance Eligibility Test:

Apply the eligibility test only when determining eligibility for new applicants or individuals who have not received TANF financial assistance within the last 6 months. To compute eligibility:

1.  Total all countable gross earned income, including net self-employment income.

2.  Apply the 20% earned income disregard.

3.  Apply all appropriate disregards and deductions. See Part 603, Deductions and Disregards.

4.  Add countable unearned income including assigned support. The result is net income.

If the net income is less than the payment standard, the household is considered eligible. Compute the grant amount.

If the net income exceeds the household’s payment, compute MA-only eligibility.

Grant Amount Computation:

For individuals who pass the eligibility test and individuals who are open TANF financial assistance or who received TANF financial assistance within the last 6 months.

1.  From each individual’s gross earned income, subtract the following:

- 50% earned income disregard, and

- child/dependent care deduction.

This is individual net earned income.

2.  Total all net earned income amounts. This is case net earned income.

3.  Total the unearned income for all individuals including all child support received. This is gross unearned income.

4.  Add countable gross unearned income, to the case net earned income, plus any Part B Medicare premiums paid.

5.  Subtract the allowable deductions. This is case net income.

6.  Compare the case net income to the household’s payment standard in Table B Basic Maintenance Payment Allowance and Maximum Payment Standard of Part 601. The difference is the grant amount.

TANF--Medical Assistance Computation

1.  Add the gross earned income and adjusted self-employment Income (gross business receipts minus allowable expenses) for each individual whose income must be counted. See 611.04, Determining Budgetary Units for Medical Assistance Programs for who is included. This is the individual’s adjusted gross earned income.

2.  Subtract the following from each individual’s adjusted gross earned income as applicable:

- the 20% earned income disregard (as an Employment Expense Deduction),

Exception: Applicants for HKG-185, HKG-300, HKS, and MCPW medical coverage only receive a flat $90 Employment Expense Deduction

- child/dependent care deduction.

The result is each individual’s net earned income.

3.  Total all unearned income amounts.

4.  Add all child/spousal support received.

5.  Add all net earned income, unearned income, and countable child/spousal support.

6.  Subtract allowable deductions. The result is the case net income.

7.  Compare net income to the appropriate medically needy income limits in Table C, Medical Assistance Net Income Limits and Percentages of Poverty Level of Part 601.

- If case net income is greater than the household’s protected income limit, determine medical assistance eligibility for other MA programs. See Part 617, In and Out Medical Assistance, if none of the individuals are eligible for any of the poverty-level medical assistance programs.

- If case net income is less than or equal to the household’s protected income limit, the household is eligible for medical assistance.

HCBC-DD/ABD TANF-MA Only

Individuals requesting HCBC-DD or HCBC-ABD medical assistance-only are always considered an assistance group of 1. Use the following steps to determine if the individual is income-eligible.

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

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

- If gross income is less than or equal to the nursing facility CAP, income is within categorically needy limits. See Adult Assistance Manual, Chapter 600.

2.  Subtract the 20% earned income disregard (EID) and the child/dependent care deduction from gross earned income. The result is net earned income. See See Sections 603.01, Earned Income Disregards, and 603.05, Child/Dependent Care Deduction.

3.  Add countable gross unearned income to the net earned income calculated in step 2.

4.  Subtract any allowable deductions (see Section 603, Other Allowable Deductions ). The result is net income.

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

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

- If net income is below the cost of HCBC-DD or ABD services, income is within medically needy limits;

- determine the individual’s cost of care. See Part 614, Cost of Care: HCBC-DD/ABD Medical Assistance.

- If net income is exceeds the cost of HCBC-DD or ABD services, see Part 617, In and Out Medical Assistance, to determine potential In and Out eligibility.