A-3200, Special Income Limit

Revision 16-1; Effective March 1, 2016

The special income limit applies to persons who will reside in a Medicaid-approved long-term care facility or who apply for certain Home and Community-Based Services (HCBS) waiver programs. Countable income must be equal to or less than the special income limit established by HHSC (see Appendix XXXI, Budget Reference Chart). A person must live in one or more Medicaid-certified long-term facilities at least 30 consecutive days to be eligible under the special income limit. The following are included in this group:

  • Persons of any age in Medicaid-certified nursing facilities who meet medical necessity
  • Persons of any age in Medicaid-certified sections of state supported living centers and private facilities for persons with intellectual disabilities
  • Persons age 65 and over in Medicaid-approved sections of state hospitals (institutions for mental diseases)
  • Persons applying for certain HCBS waiver programs who are not already Medicaid eligible under another coverage group covered by the waiver and who meet the waiver eligibility criteria.

Automated System Program Identifier
TIERS – ME-Nursing Facility; ME-State School; ME-Non-State Group Home; ME-State Group Home; ME-State Hospital; ME-Waivers