Topic: Categorically Needy Standard
Explanation of Lump Sum Policy and Scenarios
Intended to explain when payment can be made for ICF or ICF/IID care and which income/resource guidelines are used.
Exceptions to the rules
Link to Appendix C-1
Income is determined separately for an individual and his/her spouse for ADvantage, Nursing Home Care and Home Community Base Waiver / Intellectually Disabled (HCBW/ID) services. If the Community Spouse (CS’s) monthly gross income is less than the Maximum monthly income standard as shown on Appendix C-1, Schedule XI, the Institutionalized Spouse (IS) may deem a […]
Determining Countable Income If client has been out of their home for 30 consecutive days or longer and is now receiving ICF care, 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 beginning the 31st day out of the […]
317:35-17-9 317:35-17-10 317:35-17-11 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 […]