Page 26

25

• All income types exempted in the eligibility determination are countable in the premium calculation except TANF benefits. • The premium is calculated by adding the unearned income, gross employment income, net self-employment income (amount after allowable self-employment expenses), and net rental income. • The chart in Section 3010.20.20 is used to determine whether the income is sufficient to require a premium, and if it is, the premium amount. For a single applicant/recipient, the family size of 1 is used, and for the applicant/recipient living with a spouse, the family size of 2 is used. If both spouses are applying for or enrolled in MEDWorks, the premium amount for a family size of 2 according to the income is used, and the premium is a “couple premium”. This means that there is a single premium for the couple. This premium must be paid for both spouses to remain eligible.

3455.07.00 DEDUCTION OF IMPAIRMENT-RELATED WORK EXPENSES (MED 1) The policy in this section applies to MA D, MADW, and MADI. A deduction from the earnings of the applicant/recipient in the eligibility determination is allowed for Impairment-Related Work Expenses (IRWE) under the circumstances explained in this section. To be allowed as a deduction from earned income, the IRWE must be paid by the applicant/recipient and related to the employment of the applicant/recipient. An expense which is merely incurred but not paid is not allowable. An expense that has been, will be, or could be paid for by Medicaid, other insurance, or any other source including other state programs is not allowable. Expense payments that are made less often than monthly are prorated. One-time expenses are distributed over the redetermination period. Verification of payment of IRWEs is required. Additionally, if there is any question or inconsistency concerning the person’s need for a service which is being claimed as an IRWE, the worker can require verification of necessity from an individual knowledgeable of the situation. Attendant care services:

• Due to impairment(s), assistance is needed with personal functions in preparing at home to go to work, traveling to and from work, or while at work with personal or work-related functions.