Long Term Care (LTC): ADvantage and Other Waivers – Determining Income Eligibility

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Determining Countable Income

Countable income must be equal to or less than the Categorically Needy Standard (300% of Federal Benefit Rate) found on Appendix C-1 Schedule VIII B.1. If income is between the Categorically Needy Standard and the Maximum monthly countable income for a Medicaid Income Pension Trust, also found on Schedule VIII B.1, a Medicaid Income Pension Trust must be established and funded prior to applicant being determined financially eligible.

If payment of income is made to the individual and another person(s), the income is considered in proportion to the individual’s interest. Otherwise, we look at the income of the applicant only in determining income eligibility.

If an ADvantage Waiver applicant receives VA Aid and Attendance, the actual amount that is paid for an attendant in the home is disregarded as income. Any amount not used for an attendant in the home is countable income.

The total VA Aid and Attendance should be coded in FACS as “Other Income’ with the “VA Aid and Attendance” in the drop down indicator block. The actual verified amount paid for an attendant in the home should then be entered in the “Diverted Income” block (F107).

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