10- 144 C.M.R. ch. 332, § 7-2

Current through 2024-51, December 18, 2024

Section 144-332-7-2 - SSI - RELATED INCOME BUDGETING PROCESS

This section describes the method used to budget income of household members when eligibility is being determined for SSI - Related Medicaid (see also Part 17 - Income).

Section 2.1: Disregards

The following are deducted from the individual's or couple's gross non-excluded income in this order:

Section 2.1.1: Federal Disregard

Twenty dollars a month from earned or unearned income.

Note: The $20.00 disregard is not applied to income based on need. This means there is no $20.00 exclusion of a VA Pension or Veteran's Financial Assistance (which is based on need). The $20.00 disregard does apply to VA Compensation (which is not based on need).

Section 2.1.2: Impairment - Related Work Expenses (IRWE)

Impairment - Related Work Expenses (IRWE) are to be deducted from a SSI - Related disabled individual's gross earnings. IRWE allowable deductions and limits are outlined in Appendix B.

Section 2.1.3: Earned Income Disregard

$65.00 is deducted from earned income. One half of the remaining earnings is also disregarded. This does not pertain to Sheltered Workshop Income (See Section 2.1.5 of this Part).

Section 2.1.4: State Disregard

The State of Maine also allows an added deduction of $55.00 for an individual and $80.00 for a couple.

Note: There is no $55.00 state disregard of income when determining eligibility for State Supplement for individuals residing in residential care living arrangements defined in Part 12, Section 1.

Section 2.1.5: Special Group Disregards

I. Pickle Disregard

Individuals or couples covered under the Pickle Amendment (see Appendix C) have all Cost of Living Adjustment's (COLA's) to Social Security benefits received since the closure of concurrent entitlement for SSI or State Supplement and Social Security disregarded. This disregard applies also to COLA increases of the spouse even if the spouse is not eligible as a Pickle.

II.Disabled Adult Children Disregard

Individuals or couples receiving Social Security benefits as Disabled Adult Children have a portion of their Social Security benefits disregarded. The amount of the disregard equals the amount of either the increase in, or the initial receipt of, DAC benefits that resulted in SSI ineligibility..

The individual or couple loses this disregard when they marry, unless they marry another DAC.

III.Disabled Widow(er) (DWB) Benefit Disregard

The amount of the disregard as a Disabled Widow(er) is the amount of the Social Security benefits that caused the loss of SSI or State Supplement benefits. Disabled Widow(er)s maintain this status when they marry as long as they are still disabled.

IV.Shelter Workshop Disregard

Subtract $20 Federal disregard, if not previously deducted

Subtract $50 from remaining sheltered workshop income

Subtract 1/2 of remaining sheltered workshop income

Section 2.2: Deeming of Income

When an eligible individual is living in the same household with an ineligible spouse, or if the eligible individual is a child under age 18 residing in the same household with a parent, the income of the spouse or parent must be included in determining eligibility.

The income of an ineligible spouse, or parent living with the individual is deemed to the individual, and is combined with the applicant's own income.

Section 2.2.1: Allocation

Before income is deemed an amount is deducted from income which is set aside for the support of certain individuals other than the eligible individual. Specifically:

I.Ineligible child allocation

A. when determining eligibility for an eligible child, allow an allocation from the parent's income for each ineligible child living in the household. In a household where there is a stepparent to an eligible child, use the legal parent's income to meet the allocation for mutual children.

B. when determining eligibility for an individual or a couple, allow an allocation from the parent's income for each ineligible child living in the household.

1. for SSI, the State Supplement and when using the Pickle, DWB, or DAC disregards, an allocation is allowed only from the income of an ineligible spouse

2. in other Medicaid determinations, an allocation is allowed from the income of the eligible individual or couple as well as the ineligible spouse.

3. stepparents can allocate to legal children only (including mutual), not to step-children.

4. allow an allocation for a child who is under age 22 (through age 21) and a student regularly attending school or college or training designed to prepare him/her for a paying job. The allocation can be used for a child who is away at school as long as they are considered to be temporarily absent. A child away at school is considered temporarily absent if s/he returns home on some weekends, holidays, or vacations and parent(s) have authority to make decisions on the child's behalf whether or not this authority is exercised.

5. allocations from a spouse's or parent's income for an ineligible child in the household (or temporarily absent from the household) end the month the child attains age 18, or if a student, age 22.

6. the amount of the allocation is equal to the difference between the ineligible child allocation amount in Chart 3 and the ineligible child's gross monthly income. Gross monthly income for this purpose is gross non-excluded income (Part 17) minus the specific exclusions in Section 2.2.2 of this Part.

II.Parent Allocation - when determining eligibility for an eligible child:

A. deduct an amount from an ineligible parent's own income when deeming parental income to an eligible child. This is the parent allocation.

B. the amount is equal to the parent'(s) allocation in Chart 3.2.

C. step-parents are not included in the parent allocation.

Section 2.2.2: Exclusions to Deeming Process

I. The following is excluded income when determining the income to be deemed from the ineligible spouse to the eligible spouse:

A. All income that is excluded for an eligible individual.

B. Income from TANF, General Assistance or federal program benefits that are based on need (such as Veteran's Pension). In addition, exclude any income that was counted or excluded by any of these benefits.

C. Income used to comply with the terms of court ordered support and Title IV-D support payments.

D. When deeming from an ineligible spouse to an eligible spouse, exclude an amount equal to the "ineligible spouse standard" in Chart 3.5. This exclusion is taken first from unearned income and any remainder is taken from earned income.

II. The following is excluded income when determining the income to be deemed from an ineligible parent to an eligible child:

Note: Income is not deemed from a stepparent. When looking at the parent allocation, look at the amount for a one-parent household. The eligible child is treated as "living with others".

A. All income that is excluded for an eligible individual.

C. Income used to comply with the terms of court ordered support and Title IV-D support payments.

III. The following is excluded income when determining the income of an ineligible child to whom an income allocation is made:

All income that is excluded for an eligible individual with one exception. There is no one-third exclusion of child support received for the ineligible child.

Note: An ineligible child allocation is not made to a child who is receiving TANF, SSI or State Supplement.

IV. When determining eligibility for a child:

If siblings receive SSI or State Supplement, treat them as eligible children in the budgeting process. Exclude the SSI or State Supplement payments the siblings receive.

Section 2.2.3: Duration of Deeming

I. Deeming ends the month after the ineligible spouse and eligible individual cease to live together for any reason.

II. Deeming from parent to child stops the month after:

A. the child reaches 18; or

B. the month after the child no longer resides with the parents for any reason.

10- 144 C.M.R. ch. 332, § 7-2