Appendix A: Determining Medical Assistance Eligibility and Payment Toward the Cost of LTC Facility Services

Income Limits

NMP-SSI Related Monthly Special Gross Income Limit--Effective 1/1/2017 (300% of Federal Benefit Rate)

$2,205.00

NMP-SSI Related Monthly Special Gross Income Limit-- Effective 1/1/2016 (300% of Federal Benefit Rate)

$2,199.00

MNO 6-Month Limit - 1 Person

$2,550.00

SSI Monthly 1 Person Limit -- Effective 1/1/2017

$757.10

Deductions

 

FSA

 

Dependent Child Maintenance Limit (No CS)

Schedule 1

$215.00

 

Schedule 2

$205.00

 

Schedule 3

$195.00

 

Schedule 4

$174.00

Disabled/Blind Child Maintenance Limit (SSI Limit)

(No CS) - Effective 1/1/2017

$757.10

Disabled/Blind Child Maintenance Limit (SSI Limit)

(No CS) - Effective 1/1/2016

$755.10

Low Income Subsidy Benchmark-Effective 1/1/2017

$39.45

Low Income Subsidy Benchmark-Effective 1/1/2016

$35.30   

 

Determining Payment toward the Cost of LTC Facility Services: Spousal Impoverishment Provisions

 

Deductions

Personal Needs Allowance Deduction
(No therapeutic activity earnings) -Effective 7/1/2007

$45.00

Shelter Cost -Effective 10/1/2015:

Heating Standard  (2015)

$570.00

Heating Standard  (2014)

$557.00

Non- Heating Standard (2015)

$296.00

Non-Heating Standard  (2014)

$289.00

Homeless Standard

$143.00

Limited SUA (Effective 10/1/ 2014)

 $55.00

Phone only

$33.00

 

Monthly Maintenance Needs Allowance

 

Minimum Monthly Maintenance Needs Allowance (MinMMNA)  Effective 7/1/2016

$2,003.00

Minimum Monthly Maintenance Needs Allowance (MinMMNA)   Effective 7/1/2015

$1,992.00

Maximum Monthly Maintenance Needs Allowance (MaxMMNA)  Effective 1/1/2017

$3,022.50

Maximum Monthly Maintenance Needs Allowance (MaxMMNA)  Effective 1/1/2016

$2,980.50

Excess Monthly Shelter Standard  Effective 7/1/2016

$601.00

Excess Monthly Shelter Standard  Effective 7/1/2015

$598.00

Dependent Living with Community Spouse Allowance  Effective 7/1/2016

$2,003.00

 

Dependent Living with Community Spouse Allowance

Effective 7/1/2015

$1,992.00

 

 

 

Protected Share

 

Maximum Protected Share          Effective 1/1/2017

$120,900.00

Maximum Protected Share          Effective 1/1/2016

$119,220.00

Minimum Protected Share           Effective 1/1/2017

$24,180.00

Minimum Protected Share           Effective 1/1/2016

$23,844.00

 

 

                              Private Pay Rates

 

Determining a Penalty Period      Effective 1/1/ 2017

 

Average Monthly Private Pay Rate

 $9,792.65

Average Daily Private Pay Rate

$321.95

Determining a Penalty Period Effective 1/1/2016

 

Average Monthly Private Pay Rate

$9,198.61

Average Daily Private Pay Rate

$302.42

 

 

Equity Limits

 

 

Excess Home Equity Limit                                   Effective  1/1/2017

$560,000.00

Excess Home Equity Limit                                  Effective  1/1/2016

$552,000.00

 

 

 

Updated December 7, 2016,   Replacing  May 11,2016