Budgeting Procedures for the Medicare Savings Programs 510-05-90-60

(Revised 1/03 ML #2833)

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All income of the applicant or recipient and other members of the Medicaid unit who are living with the applicant or recipient must be considered. Deductions for the Medicare premium, any health or nursing home insurance premiums, or any other medical expenses are not allowed.

The same budgeting applies regardless of whether the individual lives in the individual’s own home, a specialized facility , or a nursing facility.

Recipients with income at or below 100% of the poverty level can only be eligible as a QMB. If income is above 100% but not more than 120% of the poverty level, the recipient can only be eligible as a SLMB. If income is above 120% but not more than 135% of the poverty level, the recipient can only be eligible as a QI.

Individuals between the ages of 21 and 65 are not eligible for Medicaid in the state hospital.