Page 173

UPDATED: JUNE 2010

270

INCOME SINGLES/CHILDLESS COUPLES (S/CC) BUDGETING METHODOLOGY

DETERMINATION OF ELIGIBILITY

Policy: Eligibility for single persons and childless couples who are over the age of 21, but under the age of 65, and who are not certified blind, certified disabled or pregnant is determined by comparing the net available income of the A/R to the Medicaid Standard (and MBL Living Arrangement Chart as appropriate). (See REFERENCE MEDICAID STANDARD and MBL LIVING ARRANGEMENT CHART) In order for such a person to be eligible for Medicaid, s/he must meet the eligibility criteria for S/CC. (See CATEGORICAL FACTORS SINGLES/CHILDLESS COUPLES (S/CC))

NOTE: Effective April 1, 2008, the Medicaid standard is used to determine Medicaid eligibility for single individuals and childless couples, regardless of their living arrangement, since medical care is now considered an unmet need. Therefore, it is not necessary to determine if there is an unmet need. References: SSL Sect. 366

Dept. Reg. 360-3.3(a) (1)

ADMs OMM/ADM 97-2

GIS

08 MA/022

Interpretation: Eligibility for S/CC persons is determined as follows:

(1) Determine the A/R's household size by counting those persons who are applying and their legally responsible relatives (See RESOURCES PERSONAL NEEDS ALLOWANCE). An S/CC household cannot be larger than two. (2) Determine the gross monthly income of the person or household. All income from all sources is reviewed to determine if it is to be included in the eligibility determination. The income of a non-applying spouse who lives in the same household is counted in the eligibility determination process, unless such spouse refuses to make his/her income available. Certain kinds of income are disregarded in whole or in part. (See INCOME S/CC DISREGARDS) The income is converted to a monthly figure. (3) Compare the monthly income to 185% of the Medicaid Standard as described in REFERENCE MEDICAID STANDARD. If the income exceeds 185% of the Medicaid

(MRG)