Table A: Income Limits (MAM)

SR 24-01 Dated 01/24

Previous Policy

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Medical Assistance standard of need (SON)

Exceptions:

•       Some HCBS-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;

•       QDWI, 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

Categorically Needy MA

Medically Needy MA

Independent Living

•       Individual

•       & spouse

A needy essential person cannot be included in the medical assistance group

 

1

2

 

$957

$1,416

(PIL)

$888

$1,033

 

Residential Care Facility

1

$1,137

$888

Community Residence

•       Subsidized

•       Unsubsidized

•       Enhanced Family Care

 

1

1

1

 

$1,019

$1,079

$1,137

 

$888

$888

$888

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

$2,829

     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 801.06; He-W 858.03; He-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; 42 USC 1396b(f)(1)(A)-(C)