5101:1-39-20 Medicaid: computation of countable monthly income.

(A) Paragraphs (E) to (J) of this rule describe the method of computation of countable monthly income for the medicaid financial eligibility determination. This method applies only to aged, blind, and disabled individuals. Covered families and children (CFC) medicaid financial eligibility is found in Chapter 5101:1-40 of the Administrative Code.

(B) “Countable income” is defined as gross earned income and/or unearned income less appropriate disregards and is measured against the appropriate medicaid need standard. The amount of monthly countable income determines whether the assistance group is eligible or ineligible for medicaid insofar as income is concerned.

(C) Countable income is determined based on the CDJFS computation of income and circumstances which will exist in the month for which medicaid eligibility is being determined. This computation is based on the amounts, the type (i.e., earned or unearned) of income and the frequency with which the income is received.

(D) In determining the monthly allocation of income received other than monthly (e.g., quarterly, semi-annually or annually), the CDJFS shall divide the countable income of months for which the income is received, (i.e., income received annually shall be divided by twelve months, semiannually shall be divided by six months, quarterly shall be divided by three months).

(E) The computation of countable monthly income is calculated using the following guidelines.

(1) Gross monthly unearned income shall be calculated in accordance with the provisions set forth in rule 5101:1-39-20.2 of the Administrative Code. Following the computation of gross monthly unearned income, countable monthly unearned income, countable monthly unearned income shall be determined as follows:

(a) Gross monthly unearned income is rounded down to the nearest whole dollar to establish the gross monthly unearned income.

(b) Applicable exemptions and disregards are combined by category and sequentially deducted from the gross monthly unearned income. The subtotal is rounded down to the nearest whole dollar to establish the countable monthly unearned income.

(2) Gross monthly earned income shall be calculated in accordance with the provisions set forth in rules 5101:1-39-20.1 and 5101:1-39-20.2 of the Administrative Code. Following the computation of gross monthly unearned income, countable gross monthly income shall be calculated as follows:

(a) Gross monthly earned income is rounded down to the nearest whole dollar to establish the gross countable earned income.

(b) Applicable exemptions and disregards are combined by category and sequentially deducted from the gross earned income. The subtotal is rounded down to the nearest whole dollar to establish the countable monthly earned income.

(3) Combine the countable unearned income and the countable earned income to establish the total countable income.

(4) Measure the countable income to the appropriate medicaid need standard. If there is a deficit, the assistance group is financially eligible.

(F) The twenty-dollar per month disregard applicable to either earned or unearned income is applied against the unearned income and then any unused portion of the twenty-dollar disregard is applied to the earned income.

(G) All income of an ineligible spouse or parent(s) which is deemed to an assistance group is considered unearned income.

(H) The exemptions of unearned income are applied in the following order of priority:

(1) Assistance based on need;

(2) Tuition and fees, amounts of grants, scholarships and fellowships;

(3) Relocation assistance benefits;

(4) Infrequent or irregular income – twenty dollars or less per month of unearned income;

(5) Payment for providing foster care;

(6) Child support payments from an absent parent;

(7) Home produce for personal use;

(8) Twenty dollars per month disregard-one twenty-dollar disregard applied to any type of income;

(9) Other income exemptions.

(I) Earned income exclusions and disregards are to be applied in the following order of priority:

(1) Infrequent or irregular income (rounded down to the nearest whole dollar) which is ten dollars or less of earned income;

(2) Student child earned income (rounded down to the nearest whole dollar) exemption up to one thousand two hundred ninety dollars per month but not more than five thousand two hundred dollars in a calendar year.

(3) Twenty dollar per month disregard-a disregard of twenty dollars per month applies to the earned and/or unearned income received by an eligible individual and eligible spouse;

(4) Earned income disregard-sixty-five dollars plus one-half of remaining earned income per month to the combined earned income of an eligible individual and eligible spouse;

(5) Work expenses of the blind.

(6) Impairment-related work expenses.

(J) For an eligible individual, countable income is compared to the appropriate individual need standard. For an eligible couple, countable income is compared to the appropriate couple need standard. For an eligible individual with an ineligible spouse, countable income is compared to the appropriate individual need standard.

HISTORY: Eff 1-3-80; 3-1-84; 10-1-88 (Emer.); 12-20-88; 4-1-89 (Emer.); 6-18-89; 10-1-89 (Emer.); 12-16-89; 5-1-91 (Emer.); 6-17-91; 10-1-02

Rule promulgated under: RC 111.15

Rule authorized by: RC 5111.01, 5111.011

Rule amplifies: RC 5111.01, 5111.011

R.C. 119.032 review dates: 6/11/2002 and 10/01/2007