400.02 BUDGETING TYPE BASED ON CATEGORY OF ELIGIBILITY (COE)

The chart below displays the type of budget that is applicable to each active COE certified by the Division of Medicaid (DOM): AT-HOME COE’S USING ABD BUDGETING RULES (with Need Standards specified) AT-HOME COE’S USING MAGI BUDGETING RULES ME = MAGI Equivalent level is the Need Standard LONG TERM CARE COE’s USING INSTITUTIONAL BUDGETING RULES – all use 300% FBR as Need Standard 002 – SSI Retro Uses SSI FBR 007 – Former Foster Care No ME limit 010 – Nursing Facility under 300% SSI FBR 020 – SSI Limitation Cases Uses SSI FBR 029 – Family Planning Waiver ME = 194% FPL 011 – Long Term Hospital under 300% SSI FBR 021 – Emergency Services for Immigrants (need standard depends on COE placement) 021 – Emergency Services for Immigrants (need standard depends on COE placement) 012 – Swing Bed under 300% SSI FBR 025 – Working Disabled Uses 250% FPL 071 – Infants to Age 1 at/below 185% FPL. ME = 194% FPL 013 – Nursing Facility – would be SSI at-home* 027 – Women with Breast or Cervical Cancer Uses 250% FPL 072 – Children Ages 1 – 5 at/below 133% FPL. ME = 143% FPL 014 – Long Term Hospital – would be SSI at-home* Medicare Cost-Sharing: 031 – QMB – 100% FPL 073 – Children Ages 6 to 19 at/below 100% FPL. ME=107% FPL 015 – Swing Bed – would be SSI at-home* AT-HOME COE’S USING ABD BUDGETING RULES (with Need Standards specified) AT-HOME COE’S USING MAGI BUDGETING RULES ME = MAGI Equivalent level is the Need Standard LONG TERM CARE COE’s USING INSTITUTIONAL BUDGETING RULES – all use 300% FBR as Need Standard 051 – SLMB – 120% FPL 054 – QI – 135% FPL 035 – QWDI - 200% FPL 074 – Children Ages 6 to 19 with income above ME of 107% FPL but at/below 133% FPL (no ME limit) * - refer to Chapter 500, Section 500.10 for policy on recipients eligible upon entry to long term care, which is different from being determined “would be eligible at home.” 045 – Healthier MS Waiver Uses 135% FPL 075 – Parent(s) and Needy Caretakers of Minor Children under Age 18 ME levels are state set limits 019 – Katie Beckett Program 300% SSI FBR Former SSI Recipients – all use SSI FBR 093 – Cost of Living (COL) 094 – Disabled Adult Child (DAC) 095 – Widow(er) 60 + 096 – Widow(er) 50 to 60 088 – Pregnant Women with income at/below 185% FPL. ME = 194% FPL HCBS Waiver Programs: 062 – Assisted Living 063 – Elderly & Disabled 064 – Intellectual Disability 065 – Independent Living 066 – Traumatic Brain Injury 099 – CHIP Children to 19 years of age at/below 200% FPL. ME = 209% FPL