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Chapter: 2400 Budgeting Income Program: MSSI, SFP 33 2440.0000 SSI-Related Medicaid, State Funded Programs Once the eligibility specialist has determined the individual's assets (Chapter 1600) and income (Chapter 1800) according to policy, various budgets and tests must be executed to determine or redetermine eligibility. To determine how to calculate benefits, Chapter 2600 must be used. 2440.0100 INCOME LIMITS (MSSI, SFP) The income limits compared to the SFU’s countable income to determine eligibility for assistance vary by coverage group. Refer to Appendix A-9 and A-12 for the standard tables. 2440.0102 Medically Needy Income Limits (MSSI) When the standard filing unit has met the technical eligibility criteria and the asset limits, the assistance group is enrolled. There is no income limit for enrollment. The assistance group is eligible (entitled to Medicaid) once income is less than or equal to the Medically Needy Income Level (MNIL) or medical bills equal the amount by which income exceeds the MNIL. Once medical bills are equal to the share of cost, the assistance group is eligible.

The eligibility specialist must determine eligibility for Medically Needy when an assistance group's income exceeds the income limits for another full Medicaid Program. 2440.0103 Income Limits (MSSI) For ICP, HCBS, Hospice, HCDA, and PACE monthly income cannot exceed the state income standard for the appropriate coverage group.

The standard for these programs is equal to the ICP income standard, which represents 300% of the SSI Federal Benefit Rate (FBR).

In ICP institutional hospice, HCBS, or PACE applicants or recipients whose income exceeds 300% of the SSI Federal Benefit Rate may establish an income trust in order to qualify for Medicaid. This policy does not apply to Community Hospice or HCDA. (Refer to Chapter 1800 for policy on qualified income trusts.) 2440.0104 Income Limits for MEDS-AD (MSSI) This policy applies to MEDS-AD and ICP-MEDS.

Any aged or disabled Florida resident may be eligible for Medicaid under the MEDS-AD categorical coverage group if the individual has income at or below 88 percent of the Federal poverty level. 2440.0105 Income Limits for Regular COLA Protected Medicaid (MSSI) The policy in this section must be used in conjunction with Chapter 2000.

To be eligible for protected Medicaid, the individual:

1. must have been receiving both SSA and SSI in any month subsequent to April 1977; 2. is currently receiving SSA benefits; 3. must have lost SSI eligibility for any reason; and 4. would now be eligible for SSI if the SSA cost of living adjustments, which they received after they were last eligible for (and received) SSI and SSA benefits concurrently, were deducted from their countable income.