Income Eligibility Requirements

Income

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IncomeObjectivesAfter this module, participants will be able to: Identify program Income limits Identify the need for, collect, gain approval

for, and data enter an Income Trust Calculate allowable deductions and what is to

be retained in an Income Trust

Goal: To understand income eligibility rules and processes as well as the laws and problems that guide them.

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Income

Eligibility looks at the individual’s income only

Spouse’s income is considered later For children, parental income is not

considered No disregards at initial eligibility Expenses are considered later

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Income for Eligibility8.100.7.P

One spouse applying, other remains in the

community.

Applicant's Income only. Community Spouse's income does not impact

eligibility.

Both Spouses applying for HCBS

Income of each spouse is used to

determine eligibility individually

One spouse Institutionalized,

Community Spouse is now applying for

HCBS

Count Community Spouse's income AND count income received from Monthly Income

Allowance (MIA)

Children

Do not count parent's incomeFo

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Exempt Income

SSI Veteran’s Aid and Attendance (A&A) Veteran’s Unreimbursed Medical

Expenses (UME)

Reverse Mortgage payments are not income

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Countable Income

Everything else

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Regional Private Pay Limits 2018

•$8,940Region I

•$8,095Region II

•$7,605Region III

•$6,674Region IVFo

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Income Limits

$0-$2250 (300% SSI) $2250 - Regional Private Pay rate if

income trust is established

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What is a Trust?

A trust is an arrangement in which a party is given property on the condition it is used to benefit someone else.

All trusts must be approved by HCPF!Fo

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Trust Transmittal Form

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Income Trust

Establishes income eligibility for HCBS, PACE or NF

Cannot be used for initial hospital coverage (30-day med)

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How Does it Work?

There are limits on how much income can be retained by a beneficiary

Excess funds remain in the trust (as a patient payment)

HCPF is the beneficiary, the balance will be subject to Estate RecoveryFo

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HCBS Cash Flow

Income

Trust(keeps excess)

Disbursed Allowances

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HCBS Cash Flow - Alternative

Income

Client(disburses

allowances)Deposits Excess

to TrustFo

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Income Trust Roles

Settlor: Applicant makes the arrangement

Trustee: Hold and disburses income according to HCPF rules

Beneficiary: HCPF will recoup funds

HCPF will NOT act as Trustee!Fo

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Allowable Disbursements

Personal Needs Allowance (PNA) Monthly Income Allowance (MIA) Dependent allowance Trust maintenance fees Mandatory tax withholdings Nursing Facility patient paymentsFo

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Calculation Sheets

Will help sort this out for you

One for NF, one for HCBS

Includes all allowable disbursementsFo

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Retainable by Applicant

$2250 for HCBS, PACE (300% SSI) $84.41 for NF (2018)

$90 for some VA veterans and widow(er)s

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Monthly Income Allowance

Designed to ensure that the Spouse’s basic needs are met

Calculated using spouse’s income, shelter and medical expenses

Allows access to institutionalized spouse income to meet needs

Must be made available to spouseFo

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Minimum Basic Allowance

Minimum standard set for basic needs Also called Minimum Monthly

Maintenance Needs Allowance (MMMNA) Updated every July Currently $2030

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Maximum Allowance

Takes into consideration actual shelter costs

Cap on allowance May be called Maximum MMMNA, MMMNA

maximum or also MMMNA! Updates every JanuaryFo

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Dependent allowance

For each additional tax dependent member of the household

1/3 of the minimum allowance ($677)

Minus the dependent’s income Fo

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Other

Trust Maintenance Fees Earned income while in an institution Authorized Health Insurance and ‘Special

Medical Services’

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Income Trust Data Entry

Name of Transfer Recipient: ApplicantAmount Transferred: Enough to adjust income below $2250Reason: Income Trust approved by HCPFSource: Trust Officer

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Trust Accounting

Eligibility Sites will keep track of how much should be in the Income Trust

Perform checks at Redeterminations

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Practice!

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Income Wrap-upObjectivesCan you? Identify program Income limits Identify the need for, collect, gain approval

for, and data enter an Income Trust Calculate allowable deductions and what is to

be retained in an Income Trust

Goal: To understand income eligibility rules and processes as well as the laws and problems that guide them.

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Questions?

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