Revision 24-2; Effective June 1, 2024

Community-Based Programs Using SSI Limits (DAC, Pickle, Widow(er)s)

Income — Effective Jan. 1, 2024, total countable income must be less than the Supplemental Security Income (SSI) federal benefit rate (FBR) with the exclusion of certain increases in Social Security benefits:

  • Individual — $943
  • Couple — $1,415
  • Deeming amount — $472

Resources — Total countable resources must be no more than the limit:

  • Individual — $2,000
  • Couple — $3,000
  • Companion — $3,000

In-Kind Support and Maintenance (Community Living Arrangement)

Effective Jan. 1, 2024:

  • One-third of the SSI FBR:
    • Individual — $314.33
    • Couple — $471.66
  • One-third of the SSI FBR + $20:
    • Individual — $334.33
    • Couple — $491.66
  • One-half of the couple 1/3 SSI FBR:
    • Companion — $235.83
  • One-half of the couple 1/3 SSI FBR + $10:
    • Companion — $245.83

All Living Arrangements

Effective Jan. 1, 2024, the special income exemption for a student’s earned income, regardless of living arrangement, is:

  • Monthly earnings — $2,290
  • Annual earnings — $9,230

Related Policy

Student Earnings, E-2220

Medicare Savings Programs (MSP)

Income limits are based on the federal poverty level (FPL).

Income — Effective March 1, 2024, total countable income must be:

  • QMB — Not more than 100% FPL:
    • Individual — $1,255
    • Couple — $1,704
    • Deeming amount — $449
    • Medicaid benefits are:
      • Part A premiums
      • Part B premiums
      • Deductibles
      • Coinsurance
  • SLMB — Greater than 100% FPL, but less than 120% FPL:
    • Individual — $1,255.01 to < $1,506
    • Couple — $1,704.01 to < $2,044
    • Deeming amount — $538
    • Medicaid benefits are:
      • Part B premiums
  • QI-1 — At least 120% FPL, but less than 135% FPL:
    • Individual — $1,506 to < $1,695
    • Couple — $2,044 to < $2,300
    • Deeming amount — $605
    • Medicaid benefits are:
      • Part B premiums
  • QDWI — No more than 200% FPL:
    • Individual — $2,510
    • Couple — $3,407
    • Deeming amount — $897
    • Medicaid benefits are:
      • Part A premiums

Note: These income limits do not include the $20 disregard for MSP.

Resources — Effective Jan. 1, 2024, total countable resources must be:

  • QMB, SLMB, QI-1 — No more than the limit:
    • Individual — $9,430
    • Couple — $14,130
  • QDWI — No more than twice the SSI resource limit:
    • Individual — $4,000
    • Couple — $6,000

Medicaid Buy-In (MBI) Program

Income — Effective March 1, 2024:

  • Income eligibility is based on earnings.
  • Countable earned income must be less than the limit:
    • 250% of FPL — $3,138

Resources — Total countable resources must be no more than the limit of $2,000.

MBI Monthly Premiums: Countable Unearned Income Minus (−) SSI FBR of $943 Plus (+) Earned Income Premium

Unearned Income Premium
Countable Unearned Income Minus (−) SSI FBR $943

Earned Income Premium

Countable Earned Income Based on FPL Range

FPLDollar RangeEarned Income Premium
at or below 150% FPL Less than or equal to $1,883$0
150%–185% of FPLGreater than $1,883 up to and including $2,322$20
>185%–200% of FPLGreater than $2,322 up to and including $2,510$25
>200%–250% of FPLGreater than $2,510 up to and including $3,138$30
>250% of FPLGreater than $3,138$40

If the unearned income premium amount plus the earned income premium amount equals or exceeds $500, then the total monthly premium remains at $500.

Medicaid Buy-In for Children (MBIC) Program

Resources — No resource test for MBIC.

Income — Effective March 1, 2024:

  • MBIC income exclusion — $85 plus one-half of the remaining income.
  • Eligibility — No more than 150% FPL based on family size.

These amounts do not include the MBIC income exclusion.

FPL Amounts for Income Eligibility

Family Size150% FPL
1$1,883
2$2,555
3$3,228
4$3,900
5$4,573
6$5,245
7$5,918
8$6,590

Ineligible sibling exclusion amount (150% FPL x 2 + $85) — $3,851

FPL Amounts for Premium Determination

Family Size150% FPL200% FPL300% FPL
1$1,883$2,510$3,765
2$2,555$3,407$5,110
3$3,228$4,304$6,455
4$3,900$5,200$7,800
5$4,573$6,097$9,145
6$5,245$6,994$10,490
7$5,918$7,890$11,835
8$6,590$8,787$13,180

MBIC Premiums — No Employer-Sponsored Insurance (ESI)

Family IncomeFamily of 1 or 2 Premium AmountFamily of 3 or More Premium Amount
At or below 150% FPL$0$0
151–200% FPL$90$115
201–300% FPL$180$230

MBIC Premiums — ESI with State-Paid Health Insurance Premium Program (HIPP)

Family IncomeFamily of 1 or 2 Premium AmountFamily of 3 or More Premium Amount
At or below 150% FPL$0$0
151–200% FPL$25$35
201–300% FPL$50$70

MBIC Premiums — ESI and No State-Paid HIPP

No MBIC premium.

Medicare Premiums

Effective Jan. 1, 2024

Part A Premium (Hospital Insurance):

  • $0 — Most people do not pay a monthly Part A premium because they or a spouse have 40 or more quarters of Medicare-covered employment.
  • $505 — Standard Medicare Part A monthly premium cost — The monthly Part A premium for people who are not eligible for premium-free hospital insurance and who have less than 30 quarters of Medicare-covered employment.
  • $278 — Reduced Medicare Part A premium — The monthly Part A premium for people who have 30–39 quarters of Medicare-covered employment.

Part B Premium (Medical Insurance):

  • $174.70 — 2024 standard Medicare Part B monthly premium.

Staff must use the Medicare Part B amount as verified in the State Online Query (SOLQ).

Related Policy

Medicare Part B Premium, H-1800

Community Attendant Services (CAS)

Income — Effective Jan. 1, 2024, total countable income must be no more than the special income limit:

  • Individual — $2,829
  • Couple — $5,658

Resources — Total countable resources must be no more than the limit:

  • Individual — $2,000
  • Couple — $3,000

Institutional Living Arrangement (People living in a Medicaid certified long-term care facility or receiving Home and Community Based Waiver services)

Individual or Couple Eligibility Budget

Special income limit — The special income limit for an individual is equal to or less than 300% of the SSI federal benefit rate.

Income — Effective Jan. 1, 2024, total countable income must be no more than the special income limit:

  • Individual — $2,829
  • Couple — $5,658

Resources —Total countable resources must be no more than the limit:

  • Individual — $2,000
  • Couple — $3,000
  • Substantial home equity — $713,000
  • Transfer of assets (TOA) divisor — $242.13 daily rate (effective Sept. 1, 2023)

Note: The Transfer of Assets daily rate is reviewed every other year.

Co-Payment

Individual or Couple Co-Payment Budget:

  • Personal Needs Allowance (PNA) —
    • $75 (nursing facility recipient)
    • $75 plus the Protected Earned Income (PEI) amount (recipient in an ICF/IID facility)
    • $85 (recipient in foster care or assisted living)
    • $2,829 (HCBS waiver recipient)
  • Guardianship Fees — Varies
  • Dependent Allowance — $943
  • Incurred Medical Expenses — Varies
  • Deduction for Home Maintenance — Up to $943

Spousal Co-payment Budget:

  • Personal Needs Allowance (PNA) —
    • $75 (nursing facility recipient)
    • $75 plus the Protected Earned Income (PEI) amount (recipient in an ICF/IID facility)
    • $85 (recipient in foster care or assisted living)
    • $2,829 (HCBS waiver recipient)
  • Guardianship Fees — Varies
  • Minimum Monthly Maintenance Needs Allowance (MMMNA) (Spousal allowance) — $3,853.50
  • Spousal Impoverishment Dependent Allowance — $2,465 (effective July 1, 2023)
  • Incurred Medical Expenses — Varies

Calculation of the Spousal Protected Resource Amount (SPRA):

  • SPRA is the greater of:
    • one-half of the couple's combined countable resources; or
    • the minimum resource amount set by federal law (SPRA minimum — $30,828); but
    • SPRA is not to exceed the maximum resource amount set by federal law (SPRA maximum — $154,140).

Income-first minimum monthly maintenance needs allowance (MMMNA) for SPRA expansion (Spousal Allowance) — $3,853.50

Related Policy

Personal Needs Allowance (PNA), H-1500
Guardianship Fees, H-1550
Dependent Allowance, H-1600
Deduction for Home Maintenance, H-1700
Incurred Medical Expenses, H-2000
Spousal Impoverishment Dependent Allowance, J-7400