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the Independence Account is approved. Continue to count the initial balance and any dividends, interest, and deposits to the account during periods of MAPP ineligibility as a countable asset. 26.4.2 Income The spouse and applicant or member’s net income must not exceed 250% of the FPL (See 39.5 FPL) for appropriate fiscal test group size. To determine this, do the following: 1. Determine earned income. Count the member and their spouse’s income if residing together. 2. Deduct the $65 and ½ of the earned income disregard from the spouse and member’s earnings (see SECTION 15.7.5 $65 AND ½ EARNED INCOME DEDUCTION). 3. Deduct the member’s and spouse's IRWEs (see SECTION 15.7.4 IMPAIRMENT RELATED WORK EXPENSES (IRWE)). The result is the adjusted earned income. 4. Determine unearned income. Count the applicant or member's unearned income and their spouse’s unearned income if residing together. 5. Add the adjusted earned and unearned income together. 6. Deduct $20 from the combined income. 7. Deduct special exempt income (see SECTION 15.7.2 SPECIAL EXEMPT INCOME). 8. Deduct all verified monthly out-of-pocket medical and remedial expenses incurred by a MAPP applicant or member (their spouse, if living together), if the monthly total of those expenses is above $500. 9. If a MAPP member receives Social Security payments, subtract the current COLA disregard between January 1 and the date the FPL is effective in CARES for that year (see SECTION 15.3.35 TEMPORARY COLA DISREGARD FOR SOCIAL SECURITY RECIPIENTS). 10. Subtract the disregard amount for MAPP members who are also determined to be a 503 (see SECTION 25.3 503 GROUP) or Disabled Adult Child (DAC) (see SECTION 25.2 DISABLED ADULT CHILD (DAC) GROUP). 11. Compare the result to 250% of the FPL (see SECTION 39.5 FPL TABLE). Include the member’s minor dependent legal children (biological or adoptive) when determining fiscal test group size. Include the member's dependent 18-year-old children in the fiscal test group size. Do not include the member’s stepchildren. 26.4.2.1 Deduction for Medical and Remedial Expenses over $500 For MAPP only, if an applicant or member (or his or her spouse, if living together) has verified monthly out-of-pocket medical and remedial expenses that total over $500, the total amount of these expenses will be deducted from the applicant or member’s and his or her spouse’s income when determining whether that income is above 250% FPL in the calculation shown in 26.4.2 INCOME. Example 7 Shelly applies for MAPP. She verifies $350 in out-of-pocket remedial expenses for herself and $200 in out-of-pocket medical expenses for her spouse that cannot be covered by MAPP or any other third party. $550 will be deducted from income as a part of Shelly’s eligibility determination.

Example 8 Mary applies for MAPP. She verifies $600 in monthly out-of-pocket medical and remedial expenses, which brings her under the 250 percent of FPL income limit for MAPP. It is possible that these expenses might be covered by MAPP once Mary is eligible, but the IM worker correctly processes the application using these verified out-of-pocket expenses. One month later, Mary realizes that MAPP is now paying for $500 of these medical and remedial expenses. Mary is required to report this change in expense within 10 days. She reports that her medical expenses have dropped to $100. The IM worker enters this