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MEDICAL SERVICES POLICY MANUAL,SECTION E

E 100 FinancialEligibility

Category Income Limit Resource Limit ARKids A 142% of FPL * No Resource Test ARKids B 211% of FPL * No Resource Test Newborns No Income Test Eligibility is based on mother’s Health Care eligibility at child’s birth No Resource Test Pregnant Women: FullPregnantWoman Unborn Child 209% FPL* 209% of FPL * No Resource Test Parentand Caretaker Relative 1 person: $124.00 2 person: $220.00 3 person: $276.00 4 person: $334.00 5 person: $388.00 See Appendix F for household sizes over 5. No Resource Test Adult Expansion Group 133% of FPL * No Resource Test MedicallyNeedy: Exceptional (EC) Spend Down (SD) EC – may not exceedthe monthly income limit SD – may exceedthe quarterly income limit See MS O-710 forthemonthly and quarterly income limit 1 person: $2,000 2 person: $3,000 3 person: $3,100 TEFRA 3 times the SSIPayment Standard Appendix S $2000 Autism 3 times the SSIPayment Standard Appendix S $2000 Long-Term Services & Supports: Nursing Facility, DDS, ARChoices, 3 times the SSI Payment Standard Individual $2000 Appendix S Couple $3000