Page 6

6

(PML). Medicaid pays the remainder up to the Medicaid reimbursement rate. Step II procedures are different than Step I procedures. DO NOT USE DEDUCTIONS OR NET COUNTABLE INCOME FROM STEP I IN STEP II. In this step, do not apply passalong.

1. Establish Gross Income for STEP II

Establish gross amounts of all types of income, earned or unearned, that are countable based on policy in MA-2250, Income.

a. Count actual amount of SSA benefit received if it is reduced to recoup an SSA overpayment.

b. Count total VA benefit received in excess of the $90 improved pension, including Aid and Attendance (A&A) and unreimbursed medical expenses (UME), for veterans who reside in a North Carolina State Veterans Nursing Home.

2. Subtract Operational Expenses

Subtract operational expenses produced on income-producing real/personal property, or from income produced through the operation of a business. Refer to MA-2250, Income

3. Subtract the following personal needs allowances:

The total deduction for all four types of personal needs allowances cannot exceed the PLA medically needy full maintenance level for the budget unit. This means $242 for an individual or $317 for a couple who share the same room, and both receive Medicaid to pay for cost of care.

a. Personal Needs Allowance (PNA)

(1) $70 for an institutionalized individual, or

(2) $140 for a married couple who share a room.

b. Personal Needs Allowance for court-ordered guardianship fees:

(1) Guardianship fees are deducted only for an individual with a ‘guardian of the estate’ named by the court. Verify the actual amount paid based on the annual report of receipts and disbursements filed with the clerk of court or with the guardian until the first report is filed.

(2) Deduct the lesser of the following amounts: