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(a)If the a/b's income on Line 13 is equal to or less than…#
(a) If the a/b's income on Line 13 is equal to or less than the N income level for an individual, the a/b is financially eligible for N coverage.
(b)If the a/b's income on Line ll is greater than the N…#
(b) If the a/b's income on Line ll is greater than the N income level for an individual, the case must be evaluated under the medically needy income level. Coverage under N classification can never have deductibles.
(2) Medically Needy: Enter the M income amount on Line 14 and subtract this amount from Line 13. Use the amount of excess income on Line 15 to compute the deductible for the certification period.
(3) M-QB (Q, B or E): If the M-QB (Q, B or E) amount was entered on Line 14 and there is no excess income on Line 15, the a/b is eligible for M-QB provided they have Medicare.
V. MQB Family size budgeting
Because of a court ruling, DHB must determine MQB eligibility based upon “family size,” which includes the a/b, the spouse if there is one, and any dependent children under age 18 living in the home. The decision of the court applies to all MQB classifications. Although MAABD budgeting is not affected, budgeting for dual eligible is impacted by the change in methodology.
System changes are needed to accommodate more MQB maintenance levels and income limits for MAABD and MQB dual eligible. System changes to accommodate the new budgeting methodology cannot be made at this time. However, we must take those steps which are immediately possible to comply with the court ruling.