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MEDICAID ELIGIBILITY MANUAL Revised 03/01/2023 1/1/2022 3/1/2022 1/1/2023 3/1/2023 Part A $499.00 N/A $506.00 N/A Part B $170.10 N/A $164.90 N/A SSI Individual FBR Own Household (LA-A) $841.00 N/A $914.00 N/A Title XIX Facility (LA-D) $30.00 N/A $30.00 N/A SSI Couple FBR Own Household (LA-A) $1,261.00 N/A $1,371.00 N/A Deeming Allocation-Ineligible Child $420.00 N/A $457.00 N/A Presumed Maximum Value (PMV) Individual $300.33 N/A $324.67 N/A Couple $440.33 N/A $477.00 N/A SSI RESOURCE LIMITS Individual $2,000.00 N/A $2,000.00 N/A Couple $3,000.00 N/A $3,000.00 N/A Individual $4,000.00 N/A $4,000.00 N/A Couple $6,000.00 N/A $6,000.00 N/A Individual $24,000.00 N/A $24,000.00 N/A Couple $26,000.00 N/A $26,000.00 N/A Individual N/A $1,133.00 N/A $1,215.00 Couple N/A $1,526.00 N/A $1,644.00 Individual N/A $1,529.00 N/A $1,641.00 Couple N/A $2,060.00 N/A $2,219.00 Individual N/A $1,359.00 N/A $1,458.00 Couple N/A $1,831.00 N/A $1,972.00 Individual N/A $1,529.00 N/A $1,641.00 Couple N/A $2,060.00 N/A $2,219.00 Individual N/A $4,595.00 N/A $4,925.00 Couple N/A $6,169.00 N/A $6,639.00 Individual N/A $2,265.00 N/A $2,430.00 Couple N/A $3,052.00 N/A $3,287.00 Working Disabled (WD) Individual N/A $5,729.00 N/A $6,141.00 Gross earnings limit Couple N/A $7,695.00 N/A $8,283.00 Working Disabled (WD) Individual N/A $2,832.00 N/A $3,038.00 Need Standard 250% FPL Couple N/A $3,815.00 N/A $4,109.00 Working Disabled (WD) Individual N/A $1,529.00 N/A $1,641.00 Unearned income limit 135% FPL Couple N/A $2,060.00 N/A $2,219.00 Qualifying Individuals (QI) 135% FPL Qualified Working Disabled Individuals Gross earnings limit Qualified Working Disabled Individuals (QWDI) 200% FPL LIBERALIZED RESOURCE LIMITS WORKING DISABLED RESOURCE LIMITS (liberalized) FEDERAL POVERTY LIMITS Qualified Medicare Beneficiaries (QMB) 100% FPL Healthier MS Waiver 135% FPL Specified Low-Income Medicare Beneficiaries (SLMB) 120% FPL RESOURCE LIMITS APPENDIX A-1-g CHART OF ABD AT-HOME NEED STANDARDS AND RESOURCE LIMITS EFFECTIVE DATE MEDICARE PREMIUMS SSI FEDERAL BENEFIT RATES