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Title 8: Medicaid Page 63 Iowa Department of Health and Human Services Employees’ Manual Chapter E: Income Non-MAGI-Related Veterans Affairs Payments Revised April 11, 2025 Payment Adjustment for Unusual Medical Expenses A person with no countable income for VA purposes is already receiving the maximum VA benefit, so none of that person’s VA benefit is attributable to unusual medical expenses. To determine the amount of VA benefits attributable to UME, contact the Department of Veterans Affairs or use the VA award letter. When sending a release to the VA, specify on the release that the information needed is the amount of the VA benefit that is attributable to UME (difference in what the benefit would be with and without UME) and not merely the amount of UME. To determine the amount of VA benefits attributable to UME from an award letter, calculate the benefit amount with and without consideration of the UME deduction.

1. Mr. A receives a veteran’s pension of $500 and has social security income of $300. The IM worker sends a release form to the Department of Veterans Affairs. The VA indicates that $100 of the $500 VA benefit is attributable to UME. Only $400 of the VA benefit is considered to determine SSA and Medicaid benefits. 2. Mr. B receives a monthly veteran’s pension of $698.00. Mr. B provides the IM worker with a copy of his VA benefit award letter. The letter indicates that the computation of Mr. B’s VA benefit amount used the annual social security income of $5,497, annual “other” income of $353.00, and annual medical expenses of $9,700.00. The IM worker determines that $488.00 of the $698.00 VA pension is attributable to UME. Only $210.00 of the VA pension is considered to determine SSA and Medicaid benefits.

$

8,376.00

- 5,497.00

- 353.00

$

2,526.00 Maximum annual VA payment rate for Mr. B’s pension type Annual Social Security income used to compute VA benefit Annual “other” income used to compute VA benefit Annual VA benefit without UME deduction $2,526 divided by 12 months = $210.00 monthly benefit (rounded down to the nearest dollar) without UME deduction. This is the countable VA benefit amount for Medicaid and SSA purposes.

$ 698.00

- 210.00

$ 488.00 Monthly VA benefit with UME income deduction (actual benefit amount) Monthly VA benefit without UME income deduction Monthly VA benefit attributable to UME