0805.000.00 Eligibility

0805.015.35 Income Exemptions/Deductions

IM-81 May 17, 2019

  1. Personal Income Exemption:  Deduct a $20.00 personal income exemption.  Only one $20.00 exemption is allowed even if the income of a couple is being considered.
  2. SSI Payment:  Deduct any SSI payment received by the claimant (and spouse, if married and living together).
  3. Hospital and Medical Insurance: Deduct medical insurance premiums as paid by the claimant (and spouse, if married and living together).  The Supplemental Medical Insurance (SMI) premium will not be allowed on a non-spend down case, if the claimant is participating in Medicare – Part B, paying the premium, and receiving SSI, QMB or SLMB.  The SMI premium will be allowed on a spend down case, if the claimant is participating in Medicare – Part B and not receiving QMB or SLMB.  (If allowing the SMI premium on a spend down case causes the case to become non-spend down, the SMI premium will still be allowed).
  4. If it is verified that an insurance policy is intended to provide health insurance, the premium must be considered an incurred medical expense and deducted from countable income. 

    If an insurance policy specifies that it is designated to assist with nursing care costs while a person is a patient in a medical institution, it will be considered a health insurance policy.

    The following examples are types of insurance are reported through the TPL-1 system and allowable as a medical deduction:

    • Blue Cross
    • Blue Shield
    • Medicare Supplement policies
    • Cancer Insurance
    • Nursing Care
    • Veterans Administration
    • Other health insurance policies

    The following types of insurance are not reported through the TPL-1 system and are not allowable as a medical deduction:

    • Wage or Income Replacement policies
    • Accident policies
    • Life Insurance policies
    • Combination Life and Accident
    • Disability policies
    • Burial Insurance policies

Health and Accident policies are not allowable as a medical deduction; however, if the policy allows for direct payment to the hospital, the policy is reported through the TPL system.