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MEDICAID ELIGIBILITY MANUAL Revised 03/01/2019 1/1/2018 3/1/2018 1/1/2019 3/1/2019 Part A $422.00 N/A $437.00 N/A Part B $134.00 N/A $135.50 N/A SSI Individual FBR Own Household (LA-A) $750.00 N/A $771.00 N/A Title XIX Facility (LA-D) $30.00 N/A $30.00 N/A SSI Couple FBR Own Household (LA-A) $1,125.00 N/A $1,157.00 N/A Deeming Allocation-Ineligible Child $375.00 N/A $386.00 N/A Presumed Maximum Value (PMV) Individual $270.00 N/A $277.00 N/A Couple $395.00 N/A $405.66 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 $1,005.00 $1,012.00 N/A $1,041.00 Couple $1,354.00 $1,372.00 N/A $1,410.00 Individual $1,357.00 $1,366.00 N/A $1,406.00 Couple $1,827.00 $1,852.00 N/A $1,903.00 Individual $1,206.00 $1,214.00 N/A $1,249.00 Couple $1,624.00 $1,646.00 N/A $1,691.00 Individual $1,357.00 $1,366.00 N/A $1,406.00 Couple $1,827.00 $1,852.00 N/A $1,903.00 Individual $4,085.00 $4,113.00 N/A $4,229.00 Couple $5,479.00 $5,553.00 N/A $5,703.00 Individual $2,010.00 $2,024.00 N/A $2,082.00 Couple $2,707.00 $2,744.00 N/A $2,819.00 Working Disabled (WD) Individual $5,091.00 $5,125.00 N/A $5,271.00 Gross earnings limit Couple $6,833.00 $6,925.00 N/A $7,111.00 Working Disabled (WD) Individual $2,513.00 $2,530.00 N/A $2,603.00 Need Standard 250% FPL Couple $3,384.00 $3,430.00 N/A $3,523.00 Working Disabled (WD) Individual $1,357.00 $1,366.00 N/A $1,406.00 Unearned income limit 135% FPL Couple $1,827.00 $1,852.00 N/A $1,903.00 Qualified Working Disabled Individuals (QWDI) 200% FPL Qualifying Individuals (QI) 135% FPL Qualified Working Disabled Individuals Gross earnings limit Specified Low-Income Medicare Beneficiaries (SLMB) 120% FPL APPENDIX A-1-e CHART OF ABD AT-HOME NEED STANDARDS AND RESOURCE LIMITS LIBERALIZED RESOURCE LIMITS Qualified Medicare Beneficiaries (QMB) 100% FPL Healthier MS Waiver 135% FPL WORKING DISABLED RESOURCE LIMITS (liberalized) MEDICARE PREMIUMS SSI FEDERAL BENEFIT RATES RESOURCE LIMITS FEDERAL POVERTY LIMITS EFFECTIVE DATE