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Eligibility Policy Manual

600.00 Income

A.
Chapter
Contents
 This chapter contains the following topics.

Topic

601.00 General Information About income

602.00 Income Groups

602.01 Definitions

602.02 Marital Status

603.00 Transactions that are not Income

604.01 Advance Dated Checks

604.02 Constructively Received Income

604.03 Deferred Wages

604.04 Deposits to a Financial Account

604.05 Electronic Fund Transfers

604.06 Frequency

604.07 Infrequent or Irregular Income

605.00 Universal Income Deductions

605.01 Expenses Required as a Prerequisite to Obtaining the Income

605.02 Expense of Converting Foreign Currency

605.03 Overpayments

606.00 Verifying Income

606.01 Requesting Reductions or Waivers of Garnishments

606.02 Verification and Documentation of Income

607.00 Types of Income

607.01 Adoption Assistance (Adoption Subsidy)

607.02 Agent Fees

607.03 Agent Orange Payments

607.04 Alaska Longevity Bonus (ALB) Program

607.05 Alaska Native Claims Settlement Act

607.06 Alaska Native Regional & Village Corporation

607.07 Aleutian & Pribilof Islanders Restitution

607.08 Alimony or Spousal Maintenance

607.09 Allocated Income

607.10 AmeriCorps Network Program Payments

607.11 Annuity Payments

607.12 Austrian Social Insurance

607.13 Black Lung Benefits

607.14 Bureau of Indian Affairs (BIA) General Assistance

607.15 Census Income

607.16 Child Care Development Block Grant Account    Payments

607.17 Child Nutrition Payments (CNP)

607.18 Child Support

607.19 Contributions

607.20 Corporation

607.21 Credit Life Insurance Payments

607.22 Crime Victim Payments

607.23 Disability Insurance Payments

607.24 Disaster Assistance

607.25 Educational Assistance

607.26 Emergency Assistance

607.27 Energy Assistance

607.28 Federal Housing Assistance

607.29 Federal Pensions

607.30 Food Stamps and Other Government Food Programs

607.31 Foster Care

607.32 General Assistance (GA)

607.33 German Reparation Payments

607.34 Gifts

607.35 Hemophiliacs Infected with HIV

607.36 Home Produce for Personal Consumption

607.37 Honoraria

607.38 Income Tax Refunds

607.39 Indian Gaming Profit Distribution

607.40 Indian Land Lease Payments/Royalties

607.41 Indian Payments to Specific Native American Tribes or Groups Under Public Law

607.42 Industrial (Worker's) Compensation

607.43 Inheritances

607.44 In-Kind Income

607.45 Insurance Awards/Legal Settlements

607.46 Interest and Dividends

607.47 Interest or Other Earnings on a Dedicated Account Containing past due SSI Cash Payments

607.48 Japanese-American Restitution Payments (Japanese Reparation Payments)

607.49 Job Opportunities and Basic Skills Training

607.50 Jury Duty

607.51 Life Insurance Proceeds and Death Benefits

607.52 Loan Agreements

607.53 Medical and Social Services

607.54 Medical Insurance Payments

607.55 Military Allowances

607.56 Military Retirement

607.57 Netherlands WUV

607.58 Partnerships

607.59 Pension and Retirement Income

607.60 Prizes and Awards

607.61 Radiation Exposure Compensation Payments

607.62 Railroad Retirement Benefits

607.63 Rebates and Refunds

607.64 Recycling

607.65 Refugee Cash Payments (Refugee Assistance)

607.66 Reimbursements

607.67 Relocation Payments

607.68 Rental Income

607.69 Ricky Ray Hemophilia Relief Fund Payment

607.70 Royalties

607.71 Self-Employment

607.72 Sheltered Workshop or Work Activities Center Payments

607.73 Social Security Benefits

607.74 Spina Bifida Payments

607.75 State Supplementary Payments

607.76 Strike Pay

607.77 Summer Youth Employment and Training Program

607.78 Supplemental Security Income (SSI)

607.79 Temporary Assistance for Needy Families (TANF) Cash Assistance

607.80 Trade Readjustment Assistance

607.81 Transitional Adult Living Program

607.82 Transitional Youth Living Program

607.83 Tribal Business Grant

607.84 Tribal Work Experience Program (TWEP)

607.85 Trust Income

607.86 Tuberculosis Control

607.87 Unemployment Insurance

607.88 Uniform Transfer to Minors Act (UTMA)

607.89 Vaccine Injury Compensation Program (VICP) Payments

607.90 Vendor Payments

607.91 Veteran's Administration (VA) Benefits

607.92 Veteran's Administration (VA) Aid and Attendance and Housebound Allowances

607.93 Veteran's Administration (VA) Clothing Allowance

607.94 Veteran's Administration (VA) Compensation

607.95 Veteran's Administration (VA) Education Benefits

607.96 Veteran's Administration (VA) Increase for Dependents

607.97 Veteran's Administration (VA) Increases for Unusual Medical Expenses

607.98 Veteran's Administration (VA) Pension

607.99 Veteran's Administration (VA) Reduced Pension

607.100 Vocational Rehabilitation

607.101 Volunteer Service Program Payments

607.102 Wages

607.103 Wage Related Payments

607.104 Work Investment Act (WIA)

607.105 Work Related Unearned Income

607.106 Work Study Program Income of College Students

608.00 Expenses Exceed Income

609.00 Income Deeming

609.01 Parental Deeming

609.02 Sponsor Non-Citizen Deeming

609.03 How to Verify Sponsorship for Sponsor Non-Citizen Deeming

609.04 Sponsor Non-Citizen Deeming Exception for Indigent Customer

609.05 Sponsor Non-Citizen Deeming Exception for Victims of Domestic Violence and Extreme Cruelty

609.06 Sponsor Non-Citizen Deeming Exception Due to Forty Qualifying Quarters of Work

609.07 Deeming the Sponsor's Income

610.00 Income Deductions

610.01 Child Support Deductions

610.02 Student Earned Income Exclusion

610.03 General Income Deduction

610.04 Standard Work Expense Deduction

610.05 Impairment Related Work Expenses (IRWE)

610.06 One-half Work Expense Deduction

610.07 Blind Work Expenses

610.08 Child Allocations

611.00 How to Calculate Income Eligibility for ALTCS

611.01 ALTCS SSI Cash/Title IVE

611.02 ALTCS Gross Income Test Calculation (Non-Community Spouse)

611.03 ALTCS Gross Income Test Calculation (Community Spouse)

611.04 ALTCS Net Income Test Calculation (Acute Care)

611.05 S.O.B.R.A. Income Eligibility for ALTCS

612.00 How to Calculate Income Eligibility for SSI-MAO

612.01 How to Calculate Income Eligibility for SSI Non-cash

612.02 How to Calculate the Special Income Disregard for Pickle

612.03 How to Calculate the Special Income Disregard for DAC

612.04 How to Calculate the Special Income Disregard for DWW

613.00 How to Calculate Income Eligibility for AHCCCS Freedom to Work

614.00 How to Calculate Income Eligibility for Medicare Cost Sharing

615.00 How to Calculate Premium Income for SSDI -Temporary Medical Coverage

615.01 Projecting Income

615.02 Averaging Income

615.03 Converting Income to Monthly Amount

615.04 Unconverted Income

615.05 Prorating Income

616.00 Income Standards

 

B.
Introduction
 This chapter provides information about how to determine income eligibility for ALTCS, SSI-MAO, AHCCCS Freedom to Work (AHCCCS FTW), and Medicare Cost Sharing (MCS).

 

601.00    General Information About Income

 

A. Policy

To be eligible for ALTCS, SSI-MAO, AHCCCS Freedom to Work, and Medicare Cost Sharing, the customer's income must be less than or equal to the appropriate income limit. Income limits and calculations differ for the programs. 

The income of responsible relatives may be considered to be available to the customer in determining eligibility. (See MS 602.00 for information regarding income groups.)

 

B. Definition of Income

Income is cash received that can be used to obtain food, clothing, or shelter. It can be paid to the person directly or deposited into the person's financial account.

Cash includes currency, checks, and money orders.

 

C. Income Categories

Income is divided into two major categories, earned and unearned. 

• Earned income is cash received as wages, salaries, commissions, or profits from activities in which an individual is engaged as a self-employed person or an employee.

• Unearned income is cash income received from sources other than employment or self-employment. 

Within each category there are numerous types of income.

 

D. Treatment

Each type of income is either counted or excluded. When determining income eligibility, see the treatment section under each type of income in MS 607.00. 

When income is countable, count income in the month it is received or made available to the individual for whom it is intended. When income was earned during a prior month count it for the month in which it is received.

 

E. Budgeting

A control date is any month for which eligibility is being determined. 

Consider all counted income received, or expected to be received by the members of the income group during the control date in determining eligibility. (MS 606.01)

 

F. Budgeting for Community Spouse Cases

For a Community Spouse case, income eligibility is determined using community spouse rules. 

Under Community Spouse policy, income eligibility (MS 611.03) may be calculated in one of two ways. 

• The community property calculation (MS 611.03.E, and

• The name on check calculation (MS 611.03.H).

 

Always use the community property calculation first. 

Use the name-on-check calculation only when the customer is not eligible using the community property calculation.

 

G. Deductions

Some deductions may be applied in determining the amount of gross income that is used for eligibility and ALTCS share of cost calculation. (MS 605.00.) 

Other deductions from income are based on the type of income and the program. (See MS 610.00)

 

602.00 Income Groups

 

A. Definition

An income group consists of the individual(s) whose income, or who's presence in the household, is considered for the customer's income eligibility determination.

 

B. Whose Income is Considered?

Whose income is considered depends on:

• The program the customer is applying for or receiving; and

• Who the customer is residing with.

 

C. Applying or Receiving Long Term Care

If the customer is applying for or receiving long term care, always verify the customer's income for the income eligibility determination, and if applicable, the share of cost calculation. 

Sometimes, the other person's income needs to be verified for income eligibility and/or for the purpose of calculating the share of cost. Verify all income that could affect the customer's eligibility to ensure that the customer receives all the appropriate share of cost deductions.
 

TABLE KEY:

$ = This person's income is used for the income eligibility determination and/or share of cost determination.

HH = This person must be designated as a household member in ACE.

Italics in last column = The lack of verification of this person's income should not prevent dispositioning the action. However, it may affect the calculations (eligibility or share of cost)

 

IF the customer is. . .

AND. . .

AND. . .

Then the Income Group includes. . .

AND the SOC Group is. . .

THEN verify the income of. . .

Unmarried child <18

Lives with at least 1 ineligible parent(s) (home)

Resources

<$2,000

Customer ($, HH) 

 

(Income Test: 300% Gross)

(MS 611.02)

• Customer ($, HH)

• Dependent children ($, HH)

 

(MS 1201.00)

• Customer

• Dependent children

 

 

Resources

 < $2000 & refuses HCBS services

• Customer ($, HH)

• Ineligible parent(s) ($, HH)

• Dependent children ($, HH)

• Siblings ($, HH)

 

(Income Test: 100% Net)

(MS 611.04.H)

N/A

 

(Only eligible for ALTCS acute care)

• Customer

• Ineligible parent(s)

• Dependent children

• Siblings

 

 

Resource

>$2,000

• Customer ($, HH)

• Parents ($, HH)

• Dependent children (HH)

• Siblings (HH)

 

(Income Test: S.O.B.R.A.)

(MS 611.05)

• Customer ($, HH)

• Dependent children ($, HH)

 

(MS 1201.00)

 

• Customer

• Parents

• Dependent children

 

Does not live with parent(s)

Resources

 < $2,000

Customer ($, HH)

 

(Income Test: 300% Gross)

(MS 611.02)

• Customer ($, HH)

• Dependent children ($, HH)

 

(MS 1201.00)

• Customer

• Dependent children

 

or lives with eligible parent(s) (1 eligible parent if 1 parent household or 2 eligible parents if 2 parent household)

Resources

 < $2,000

 

and

 

Living in an alternative residential setting where ALTCS services cannot be provided (MS 519.03.C)

• Customer ($, HH)

• Dependent children $, HH)

 

(Income Test: 100% Net)

(MS 611.04.D)

N/A

 

(Only eligible for ALTCS acute care)

• Customer

• Dependent children

 

 

Resources

 > $2,000

• Customer ($, HH)

• Dependent children (HH)

 

(Income Test: S.O.B.R.A.)

(MS 611.05)

• Customer ($, HH)

• Dependent children ($, HH)

 

(MS 1201.00)

• Customer

• Dependent children

Age 18 or married child under age 19

Has a community spouse

During the Initial Period

• Customer ($, HH)

• Spouse ($, HH)

 

(Income Test: 300% Gross)

(MS 611.03)

 

• Customer ($, HH)

• Spouse ($, HH)

• Dependent children ($, HH)

 

(MS 1201.00)

• Customer

• Spouse

• Dependent children

During Post-Initial Period

 

 

Refuses HCBS

Note:  When the customer refuses HCBS, community spouse rules are not applicable.  Use income group that applies for a customer who is not legally married and refuses HCBS.

 

 

Resources

 > $2,000

• Customer ($, HH)

• Spouse ($, HH)

• Dependent children (HH)

• Unborn children (HH)

 

(Income Test: S.O.B.R.A.)

(MS 611.05)

• Customer ($, HH)

• Spouse ($, HH)

• Dependent children ($, HH)

 

(MS 1201.00)

• Customer

• Spouse

• Dependent children

 

Lives with a spouse (not legally married)

Living at home or together in an alternative residential setting

• Customer ($, HH)

 

(Income Test: 300% Gross)

(MS 611.02)

 

• Customer ($, HH)

• Spouse ($, HH)

• Dependent children ($, HH)

 

(MS 1201.00)

• Customer

• Spouse

• Dependent

Children

 

 

Living together in an alternative residential setting in which ALTCS services cannot be provided (MS 519.03.C)

 

or

 

Customer refuses HCBS

• Customer ($, HH)

• Spouse ($, HH)

• Dependent children ($, HH)

 

(Income Test: 100% Net)

(MS 611.04.F)

N/A

(Only eligible for ATLCS acute care)

• Customer

• Spouse

• Dependent

Children

 

 

Resources

 > $2,000

• Customer ($, HH)

• Spouse ($, HH)

• Dependent children

• Unborn children

 

(Income Test: S.O.B.R.A.)

(MS 611.05)

• Customer ($, HH)

• Spouse ($, HH)

• Dependent children ($, HH)

 

(MS 1201.00)

• Customer

• Spouse

• Dependent

Children

 

Single

Resources

<$2,000

• Customer ($, HH)

 

(Income Test: 300% Gross)

(MS 611.02)

• Customer ($, HH)

• Dependent Children ($, HH)

 

(MS 1201.00)

• Customer

• Dependent children

 

Resources

<$2,000; and

Living in an alternative residential setting where ALTCS services cannot be provided (MS 519.03.C); or refuses HCBS

• Customer ($, HH)

• Dependent children ($, HH)

 

(Income Test: 100% Net)

(MS 611.04.D)