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Manual Title Chapter Page Revision Date Virginia Medical Assistance Eligibility M03 April 2024 Subchapter Subject Page ending with Page M0320.000 AGED, BLIND & DISABLED GROUPS M0320.400 27

Accounts are also excluded in all future Medicaid determinations for former MEDICAID WORKS enrollees. The account must be exclusively used to hold resources accumulated while in MEDICAID WORKS (including interest) in order for the exclusion to continue.

4) For all other resources, the resource requirements in chapter S11 and Appendix 2 to chapter S11 apply. All of the individual's countable, nonexempt resources must be verified and evaluated. All nonexempt resources must be added together to determine if the individual meets the Medicaid resource requirements. The resource limit for resources not excluded in 1) or 2) above is $2,000 for an individual. 3. Income a. Initial eligibility determination For the initial eligibility determination on or after January 20, 2024, the limit for total countable income (unearned and earned) is less than or equal to 138% of the FPL ($1,732 per month for an individual or $2,268 when the applicant has an ABD spouse who is also applying for or covered by Medicaid). Use the rules in chapter M08 to determine income in the month of application. Individuals who receive SSI or who have 1619(b) status are considered to meet the income requirements and no evaluation of income is necessary for the initial eligibility determination (see M0320.101).

b. Ongoing eligibility Once the individual is enrolled in MEDICAID WORKS, the following income policies apply:

1) The income limit for earned income is $6,250 per month ($75,000 per year) (no change for 2024) as long as the funds are deposited in a WIN Account. The policy for determining countable earned income is contained in subchapter M0820.

If the individual is self-employed, net earnings from self-employment (NESE) must be demonstrated through documentation of Internal Revenue Service (IRS) filings, quarterly estimated taxes, business records, and/or business plans. The individual’s signed allegation of self-employment is acceptable if no other evidence of NESE can be obtained. Follow the policy in M0820.220 for determining NESE.

2) The income limit for unearned income remains less than or equal to 138% of the FPL. The policy for determining countable unearned income is contained in subchapter M0830.

3) Any increase in an enrollee’s Social Security Disability benefits resulting from employment as a MEDICAID WORKS participant OR as a result of a COLA adjustment to the Social Security Disability benefits will not be counted as long as the increase is regularly deposited upon receipt into the individual’s WIN account.

4) Unemployment insurance benefits received due to loss of employment through no fault of the individual’s own are not counted during the six- month safety net period (see M0320.400 G) as income as long as the payments are regularly deposited upon receipt into the individual’s WIN account.