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criteria, the group may be eligible for retroactive MA through the spend-down provisions which enable individuals with substantial medical bills to 'spend down' their income to qualify for Medicaid coverage (see Chapter 7: Spend-Down in this Part). AX: See AR. SR: See AR. QM: QMBs are not eligible for retroactive eligibility. For SLIMBs, QDWIs, QI-1s, and QI-2s, see AR. MC: N/A TANF N/A GC N/A FS N/A

DETERMINING BENEFITS LEVEL/AMOUNT OF ASSISTANCE 8.5 MA See Chapter 7: Spend-Down in this Part for a description of how to determine a group's spend- down liability. Groups eligible for Medicaid under the QM categories (and not otherwise eligible for Medicaid) are eligible only for full or partial reimbursement for Medicare premiums, deductibles and co-payments. Otherwise, groups determined eligible for MA are eligible for the full range of services without co-payments, premiums, or deductibles. TANF If an applicant/recipient has been found to meet all non-financial eligibility criteria, the asset test, and the income-eligibility criteria (the calculation to determine whether a group is income-eligible for TANF differs depending on whether the group is an applicant or recipient group; see Section 8.4: Determining Income-Eligibility in this Chapter), the group is eligible for TANF. The level of monthly benefits for which the group is eligible must now be determined by taking the following steps (information on how to prorate the first month's benefits based on date of application is found in Section 8.5.1: Prorating Benefits for New Applicants in this Chapter). • Determine gross countable earned and unearned income. Generally, a TANF recipient must assign the child support rights of his/her children to the District of Columbia government. Child support collected by CSED does not count as unearned income. Child support received by the family in the first two months of TANF receipt (prior to the assignment becoming effective) does count as unearned income (see Section 4.9: Child Support in this Part). After two months, the SSR should assume that CSED is collecting and retaining the group's child support. If the SSR learns that this is not the case, the SSR should inform CSED that child support is being paid to the family. The SSR should not, however, count the child support received unless the adult failed to cooperate with CSED requirements and the group is under a CSED sanction with respect to the child on whose behalf support is being received directly. • Apply applicable recipient disregards to calculate net countable income (consisting of net countable earned income and countable unearned income). Recipient disregards consist of the $160 Work Expense Deduction (per employed group member), the two-thirds (2/3) Earned Income Disregard (two-thirds of earnings not already disregarded), and the Child Care Disregard based on out-of-pocket child care expenses (see Section 6.3: Income Disregards and Deductions in this Part). In cases in which a group fails, without good cause, to report its earnings in a timely manner, the two-thirds (2/3) earned income disregard is disallowed. • Subtract net countable income from the appropriate Payment Level for the appropriate group size. Round the result to the next lowest whole dollar. If the group is eligible for