10- 144 C.M.R. ch. 332, § 10-3

Current through 2024-51, December 18, 2024

Section 144-332-10-3 - FINANCIAL ELIGIBILITY REQUIREMENTS

Section 3.1:Medically Needy Assets

Assets must be under the following limits on at least one day of the month to be eligible for that month.

For SSI - Related coverage groups:

$2000 for an individual not married or not living with a spouse, including an individual who is a child.

$3000 for an eligible couple or an individual living with an ineligible spouse There is no asset limit for MAGI-based coverage groups.

Section 3.2:Medically Needy Income

Treatment of income varies depending on whether the person is receiving Medically Needy coverage in an SSI-Related or MAGI-based coverage group.

I. For SSI-Related groups, budgeting rules in Part 7 are used to determine countable income.

II. For MAGI-based groups, budgeting rules in Part 4 are used to determine the assistance unit and countable income, except that income of a non-responsible relative is not counted when determining the deductible. A responsible relative is defined as a spouse or a biological or adoptive parent of a child under age 19.

The countable income is compared to the Protected Income Level (PIL). The PIL is based on family size and can be found in Chart 5. When the individual or family's net countable income is above the PIL a deductible must be met. Due to differences in income counting methodology applicable to categorically needy and Medically Needy coverage groups, an individual may be ineligible for coverage in a categorically needy coverage group but have countable income under the PIL for Medically Needy coverage. An individual in this situation receives Medically Needy coverage without first having to incur any medical costs.

10- 144 C.M.R. ch. 332, § 10-3