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The Special Income Level (SIL) used in determining eligibility for Institutional Residents, PACE members and for certain HCBS waivers is 300% of the SSI Maximum Benefit Rate. Effective 1-1- 26, the SIL is $2982 ( effective 1-1-25, the SIL is $2901; effective 1-1-24, the SIL is $2,829; effective 1-1-23, the SIL is $2,742; effective 1-1-22, the SIL is $2,523; effective 1-1-21, the SIL is $2,382; effective 1-1-20, the SIL is $2,349; effective 1-1-19, the SIL is $2,313; effective 1-1-18, the SIL is $2,250; effective 1-1-17, the SIL is $2,205; effective 1-1-15, the SIL is $2,199; effective 1-1-14, the SIL is $2,163; effective 1-1-13, $2,130; effective 1-1-12, $2,094; 1-1-09 through 12- 31-11, the SIL was $2,022).

The income standard for the Behavioral and Primary Healthcare Coordination Waiver (BPHC) is 300% of the Federal Poverty Level, or $3,990 effective 3-1-26.

3010.20.20 INCOME STANDARD/PREMIUMS FOR MEDWorks

The income standard for MADW and MADI is 350% of the Federal Poverty Level. Only the income of the MEDWorks member is counted in the budget. Children/parent’s income is not included, nor is income of a *spouse included when determining MEDWorks eligibility.

Example 1: Kyle and Erica are married, Kyle is disabled and has earned income; Erica is also employed but is not disabled.

Kyles gross monthly income (after allowable deductions) = $3500 Kyle is eligible for MEDWorks using only his income of $3500

Ericas gross monthly income = $5000 She is not applying for Medicaid

Kyle is income eligible for MEDWorks, the next step is to determine his premium using their combined income: The combined income = $8500 Based on the chart below, Kyles premium payment is $187

If both spouses are on MEDWorks, then each members income counts in their individual eligibility determination only, but their combined income counts in the premium calculation.

Example 2: Steve and Kathy are married, they are both disabled, and have earned income.

Steves gross monthly income (after allowable deductions) = $1900 Steve is eligible for MEDWorks using only his income of $1900

Kathys gross monthly income (after allowable deductions) = $2500 Kathy is eligible for MEDWorks using only her income of $2500