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MEDICAL SERVICES POLICY MANUAL,SECTION O O-700 Income Determination for Medically Needy Program

O 710 Medically Needy Income Levels

O-700 Income Determination for Medically Needy Program

MS Manual 01/01/14 Income is the third consideration for Medically Needy applications. Categorical relatedness and resource eligibility should be reasonably established before income eligibility is considered. Income is treated differently for the Exceptionally Needy (EC) and Spend Down (SD) groups; however, eligibility for both groups (EC and SD) is determined using the Medically Needy Income Levels below. All cases will first be considered for Exceptionally Needy and, if necessary, for Spend Down.

O-710 Medically Needy Income Levels MS Manual 01/01/14

Size of Family Unit Monthly Income Quarterly Income Annual Income 1 $108.33 $ 325.00 $ 1300 2 $ 216.66 $ 650.00 $ 2600 3 $ 275.00 $ 825.00 $ 3300 4 $ 333.33 $1000.00 $ 4000 5 $ 383.33 $1150.00 $ 4600 6 $ 441.66 $1325.00 $ 5300 7 $ 500.00 $1500.00 $ 6000 8 $ 558.33 $1675.00 $ 6700 9 $ 616.66 $1850.00 $ 7400 10 $ 675.00 $2025.00 $ 8100

Add $58.33 per month to the monthly income level or $175.00 per quarter to the quarterly income level for each additional member above family size 10.

O-720 Determination of Household Size Used for MN Income Consideration MS Manual 01/27/16 Determinationof Household Size Used for MN Income Consideration: 1. Household size for MN income determination is made as follows according to categorical consideration.