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Page 2 of 8 7/1/2026 Appendix C-1 Schedule V - Qualified Disabled and Working Individuals (QDWI) Monthly countable income and resources must be equal to or less than the following income and resource standards (200 percent of Federal Poverty Guidelines plus $20* and the earned income deduction and double Supplemental Security Income (SSI) resource standards). Refer to OAC 317:35-7-41. * $20 = amount of the monthly SSI Income Disregard Income standard Resource standard Individual $5,405 $4,000 Individual and spouse $7,299 $6,000 Schedule VI - Categorically Needy Standards for Qualified Medicare Beneficiary Plus (QMBP) Monthly countable income and resources must be equal to or less than the following income (100 percent of Federal Poverty Guidelines plus $20*) and resource standards (full benefit Medicare Part D low income subsidy resource standards). Refer to OAC 317:35-7-40. * $20 = amount of the monthly SSI Income Disregard Income standard Resource standard Individual $1,350 $9,950 Individual and spouse $1,824 $14,910 Schedule VII - Specified Low Income Medicare Beneficiaries (SLMB) Monthly countable income and resources must be equal to or less than the following income (120 percent of Federal Poverty Guidelines plus $20*) and resource standards (full benefit Medicare Part D low income subsidy resource standards). Refer to OAC 317:35-7-43. * $20 = amount of the monthly SSI Income Disregard Income standard Resource standard Individual $1,616 $9,950 Individual and spouse $2,184 $14,910