b. Couple payment levels for Iowa

Federal Code State OS Code Category FBR State Supplement Level Total Payment Levels A A Blind/Blind 1491.00 44.00 1535.00 Blind/Aged 1491.00 22.00 1513.00 Blind/Disabled 1491.00 22.00 1513.00 C Aged/Aged 1491.00 518.00 2009.00 Blind/Blind 1491.00 562.00 2053.00 Disabled/Disabled 1491.00 518.00 2009.00 Aged/Blind 1491.00 562.00 2053.00 Aged/Disabled 1491.00 518.00 2009.00 Blind/Disabled 1491.00 562.00 2053.00 D Aged/Aged 1491.00 801.00 2292.00 Blind/Blind 1491.00 845.00 2336.00 Disabled/Disabled 1491.00 801.00 2292.00 Aged/Blind 1491.00 845.00 2336.00 Aged/Disabled 1491.00 801.00 2292.00 Blind/Disabled 1491.00 801.00 2292.00 Z Aged/Aged 1491.00 0.00 1491.00 Disabled/Disabled 1491.00 0.00 1491.00 Aged/Disabled 1491.00 0.00 1491.00 B B Blind/Blind 994.00 1 44.00 1038.00 Blind/Aged 994.00 1 22.00 1016.00 Blind/Disabled 994.00 1 22.00 1016.00 H Aged/Aged 994.00 1 518.00 1512.00 Blind/Blind 994.00 1 562.00 1556.00 Disabled/Disabled 994.00 1 518.00 1512.00 Aged/Blind 994.00 1 525.00 1491.67 Aged/Disabled 966.67 1 518.00 1512.00 Blind/Disabled 994.00 1 562.00 1556.00 I Aged/Aged 994.00 1 788.00 1795.00 Blind/Blind 994.00 1 845.00 1839.00 Disabled/Disabled 994.00 1 801.00 1795.00 Aged/Blind 994.00 1 845.00 1839.00 Aged/Disabled 994.00 1 801.00 1795.00 Blind/Disabled 994.00 1 845.00 1839.00 Z Aged/Aged 994.00 1 0.00 994.00 Disabled/Disabled 994.00 1 0.00 994.00 Aged/Disabled 994.00 0.00 994.00 D Z All 60.00 2 0.00 60.00

1 Not the FBR; the amount represents the FBR less VTR.

2 Not the FBR; the amount represents a payment cap to recipients in a Title XIX institution.

NOTE: State-administered programs include recipients receiving:

• “Residential Care” and a payment based on a per diem rate plus a monthly personal allowance;

• “In-Home Health Care” and a payment based on actual cost of in-home health care plus basic Federal benefits. Treat members of a couple as individuals; or

• a supplement for Medicare and Medicaid and a $1 monthly payment.