12 Va. Admin. Code § 30-40-220

Current through Register Vol. 41, No. 9, December 16, 2024

Section 12VAC30-40-220 - Income eligibility levels

1. Groups I, II, and III income limits are set forth in this subdivision 1.

Group I
Size of assistance unit	Monthly	Yearly
1	$239	$2,868
2	364	4,368
3	464	5,568
4	563	6,756
5	663	7,956
6	748	8,976
7	844	10,128
8	945	11,340
Each additional person	98	1,176

Group II
Size of assistance unit	Monthly	Yearly
1	$313	$3,756
2	449	5,388
3	565	6,780
4	675	8,100
5	794	9,528
6	895	10,740
7	1,002	12,024
8	1,119	13,428
Each additional person	111	1,332

Group III
Size of assistance unit	Monthly	Yearly
1	$472	5,664
2	633	7,596
3	774	9,288
4	909	10,908
5	1,074	12,888
6	1,195	14,340
7	1,330	15,960
8	1,471	17,652
Each additional person	135	1,620

2. Pregnant women and infants under § 1902(a)(10)(i)(IV) of the Act. Effective January 1, 2014, based on 143% of the official federal income poverty level.

3. Children under § 1902(a)(10)(i)(VI) of the Act (children who have attained age one year but have not attained age six years), the income eligibility level is 143% of the federal poverty level (as revised annually in the Federal Register) for the size family involved.

4. For children under § 1902(a)(10)(i)(VII) of the Act (children who were born after September 30, 1983, and have attained age six years but have not attained age 19 years), the income eligibility level is 143% of the federal poverty level (as revised annually in the Federal Register) for the size family involved.

B. Treatment of cost of living adjustment (COLA) for groups with income related to federal poverty level.

1. If an individual receives a Title II benefit, any amount attributable to the most recent increase in the monthly insurance benefit as a result of a Title II COLA is not counted as income during a "transition period" beginning with January, when the Title II benefit for December is received, and ending with the last day of the month following the month of publication of the revised annual federal poverty level.

2. For individuals with Title II income, the revised poverty levels are not effective until the first day of the month following the end of the transition period.

3. For individuals not receiving Title II income, the revised poverty levels are effective no later than the beginning of the month following the date of publication.

C. Qualified Medicare beneficiaries with incomes related to federal poverty level.

The levels for determining income eligibility for groups of qualified Medicare beneficiaries under the provisions of § 1905(p)(2)(A) of the Act are as follows:

1. Section 1902(f) states, which as of January 1, 1987, used income standards more restrictive than SSI, Virginia did not apply a more restrictive income standard as of January 1, 1987.

Based on the following percentage of the official federal income poverty level:

Effective January 1, 1989: 85%

Effective January 1, 1990: 90% (no more than 100)

Effective January 1, 1991: 100% (no more than 100)

Effective January 1, 1992: 100%

D. Aged and disabled individuals described in § 1902(m)(1) of the Act; Level for determining income eligibility for aged and disabled persons described in § 1902(m)(1) of the Act is 80% of the official federal income poverty level (as revised annually in the Federal Register) for the size family involved.

E. Income levels-for medically needy. (Increased annually the increase in the Consumer Price Index but no higher than the level permitted to claim federal financial participation.

1. The following income levels are applicable to all groups, urban and rural.

2. The agency has methods for excluding from its claim for federal financial participation payments made on behalf of individuals whose income exceeds these limits.

(1)	(2)			(3)
Family Size	Net income level protected for maintenance for 12 months			Amount by which Column 2 exceeds limits specified in 42 CFR 435.1007¹
	Group I	Group II	Group III
1	$2,691.00	$3,105.00	$4,036.50	$0
2	$3,519.00	$3,824.00	$4,867.00	$0
3	$4,036.50	$4,450.50	$5,485.50	$0
4	$4,554.00	$4,968.00	$6,003.00	$0
5	$5,071.50	$5,485.50	$6,520.50	$0
6	$5,589.00	$6,003.00	$7,038.00	$0
7	$6,106.50	$6,520.50	$7,555.50	$0
8	$6,727.50	$7,141.50	$8,073.00	$0
9	$7,348.50	$7,762.50	$8,797.50	$0
10	$8,073.00	$8,487.00	$9,418.50	$0
For each additional person, add:	$695.52	$695.52	$695.52	$0

¹ As authorized in § 4718 of OBRA '90.

GROUPING OF LOCALITIES
GROUP I: Counties
Accomack	King and Queen
Alleghany	King William
Amelia	Lancaster
Amherst	Lee
Appomattox	Louisa
Bath	Lunenburg
Bedford	Madison
Bland	Matthews
Botetourt	Mecklenburg
Brunswick	Middlesex
Buchanan	Nelson
Buckingham	New Kent
Campbell	Northampton
Caroline	Northumberland
Carroll	Nottoway
Charles City	Orange
Charlotte	Page
Clarke	Patrick
Craig	Pittsylvania
Culpeper	Powhatan
Cumberland	Prince Edward
Dickenson	Prince George
Dinwiddie	Pulaski
Essex	Rappahannock
Fauquier	Richmond
Floyd	Rockbridge
Fluvanna	Russell
Franklin	Scott
Frederick	Shenandoah
Giles	Smyth
Gloucester	Southampton
Goochland	Spotsylvania
Grayson	Stafford
Greene	Surry
Greensville	Sussex
Halifax	Tazewell
Hanover	Washington
Henry	Westmoreland
Highland	Wise
Isle of Wight	Wythe
James City	York
King George
GROUP I: Cities
Bristol	Franklin
Buena Vista	Galax
Danville	Norton
Emporia	Suffolk
GROUP II: Counties
Albemarle	Loudoun
Augusta	Roanoke
Chesterfield	Rockingham
Henrico	Warren
GROUP II: Cities
Chesapeake	Petersburg
Covington	Portsmouth
Harrisonburg	Radford
Hopewell	Richmond
Lexington	Roanoke
Lynchburg	Staunton
Martinsville	Virginia Beach
Newport News	Williamsburg
Norfolk	Winchester
GROUP III: Counties
Arlington	Montgomery
Fairfax	Prince William
GROUP III: Cities
Alexandria	Fredericksburg
Charlottesville	Hampton
Colonial Heights	Manassas
Fairfax	Manassas Park
Falls Church	Waynesboro

12 Va. Admin. Code § 30-40-220

Derived from VR460-03-2.6101:1, eff. June 30, 1994; amended, Virginia Register Volume 11, Issue 10, eff. March 9, 1995; Volume 11, Issue 24, eff. October 1, 1995; Volume 17, Issue 18, eff. July 1, 2001; Errata, 17:21 VA.R. 3124 July 2, 2001; amended, Virginia Register Volume 18, Issue 7, eff. January 16, 2002; Volume 18, Issue 18, eff. July 1, 2002; Amended, Virginia Register Volume 33, Issue 21, eff. 7/27/2017.

Statutory Authority: § 32.1-325 of the Code of Virginia; 42 USC § 1396 et seq.