Page 73

UPDATED: NOVEMBER 2009

171

INCOME

BUDGETING

Description: Budgeting is the process that is used to determine the value of an A/R’s income. The budgeting of income to determine eligibility for Medicaid varies according to category.

Policy: The budgeting process involves several steps, some of which are common to all budgeting methodologies and some of which include elements that are specific to a particular category.

References: SSL Sect.

366

Dept. Reg.

360-4

ADM

OMM/ADM 97-2

Interpretation: To determine eligibility for Medicaid, five budgeting methodologies are used:

(1) Low Income Families (LIF) budgeting methodology is used for the following: • Parents living with their dependent children under age 21; • Persons under age 21; • Pregnant women; and • FNP parents.

(2) When ineligible under LIF criteria, the ADC-related budgeting methodology is used for the following: • Parents living with their dependent children under age 21; • Persons under age 21; • Pregnant women; and • FNP parents.

NOTE: This budgeting methodology is used for pregnant women and children under age 19 in determining their eligibility under the poverty levels.

(3) The SSI-related budgeting methodology is used for the following: aged (65 or over), certified blind, or certified disabled A/ Rs and for all of the Medicaid A/Rs who are applying for and determined eligible for payment or part payment of the Medicare premiums, coinsurance and deductibles. (See INCOME MEDICAID EXPANDED INCOME LEVELS)

(MRG)