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UPDATED: JUNE 2010

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INCOME ADC-RELATED BUDGETING METHODOLOGY

DETERMINATION OF ELIGIBILITY

(4) The resulting net income is compared to the appropriate income level. If the income is less than or equal to the applicable income level, the person or household is eligible for Medicaid. If the income exceeds the level for pregnant women and children under age 19, household income is compared to the applicable percentage of the federal poverty level (See INCOME MEDICALLY NEEDY INCOME AND FEDERAL POVERTY LEVELS to determine if a pregnant woman is fully eligible or eligible for prenatal services only). For pregnant women and children under the age of 19 whose income exceeds the appropriate federal poverty level, income in excess of the Medicaid level or Medicaid Standard is considered available. The resulting net income is compared to the appropriate income level. If the income is less than or equal to the applicable income level, the person or household is eligible for Medicaid. If the income exceeds the level for pregnant women and children under age 19, household income is compared to the applicable percentage of the federal poverty level (See INCOME MEDICALLY NEEDY INCOME AND FEDERAL POVERTY LEVELS to determine if a pregnant woman is fully eligible or eligible for prenatal services only). For pregnant women and children under the age of 19 whose income exceeds the appropriate federal poverty level, income in excess of the Medicaid level is considered available to meet the cost of medical care and services. Parents in a household with a deprivation, pregnant women and persons under age 21 may become eligible for Medicaid if the household incurs medical bills which equal or exceed the amount of excess income. Persons who spend down must spend down to the Medicaid level not the Medicaid Standard or poverty level. For a more detailed discussion of excess income see INCOME EXCESS SIX-MONTH.

(MRG)