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(if income is less than SSI payment level, the customer does not have to be in 30 consecutive days). If the case qualifies as a state institutional case, the case should be converted and customer will receive full Medicaid coverage and QMB coverage. When the customer is released from the institution, the case should be converted back to a QMB only case, allowing adverse action, as long as all requirements were still met. 4. Applicant applies 12/29. The case manager is able to determine eligibility on January 10 and approve as a QMB case. The case would be eligible beginning February 1. If in this same example, the customer qualifies under another category, the other category should be approved effective December with the regular Medicaid eligibility code, and beginning in February, the code should change to the Medicaid and QMB eligibility code. E-240 HEALTH INSURANCE FOR WORK ADVANCEMENT (HIWA) E-240.1 HIWA Employment-Related Work Disregards In addition to the $20 General Income Exclusion and $65 Earnings Exclusion, participants in the HIWA program are allowed Employment-Related Work Disregards (ERWD) to be subtracted from their countable earned income. The disregard must be directly related to enabling the individual with a disability to work. Expenses paid for by the employer or another party are not an allowable deduction. A. Employment-Related Transportation Expense  To and from work in personal vehicle - Allow a mileage allowance based on the current state mileage rate. (See State Administrative Manual)  To and from work in a modified vehicle - In addition to the mileage allowance, allow the cost of modifications to a vehicle necessary for the individual to get to and from work. The modification must be directly related to the individual’s impairment. NOTE: Only the cost of the modifications is allowable, not the cost of the vehicle.  Other transportation - When the individual does not have a vehicle, allow the cost of: ─ Bus fare ─ Cab fare ─ Amount paid to another individual to transport the customer to and from work. B. Employment-Related Personal Care Aid (PCA) Services Expense  Services at work or to and from work - Allow the cost for services needed in the work setting, or traveling to and from work. The cost must be incurred by the individual and not provided by the employer.  Services at home -All the cost of services needed for preparation for going to work, or needed E-235.2 Division of Welfare and Supportive Services MAABD INCOME AND BUDGETING Medical Assistance Manual Budgeting – Specific Instructions MTL 09/24 NOV 24