IM-15 February 21, 2017; IM-77 August 28, 2007
The following employment criteria must be met for each eligibility group:
- Basic Coverage Group: An individual must have earnings from employment or self-employment. For income to be considered earned income it must be documented that Medicare and Social Security taxes are withheld from such income. Self-employed persons must provide proof of payment of Medicare and Social Security taxes for income to be considered earned. Self-employed Individuals must provide copies of their tax records to verify taxes withheld or if it is a new self-employment enterprise, they must provide business records (i.e. business ledgers or gross profit statements) showing the taxes are being withheld for Social Security and Medicare. There is no minimum level of hours of employment or amount of earnings required.
NOTE: Effective February 1, 2017, participants will be considered in compliance with the statutory requirement to pay Medicare and Social Security taxes if they work in a medically related caregiver or homemaker/chore services position and the payment received is through a government agency such as DMH or DHSS where no such taxes are paid because the wages are specifically exempt and no such taxes are due.
- Medically Improved Group: An individual must have earnings from employment equal to at least 40 hours per month at the federal minimum wage. For income to be considered earned income it must be documented that Medicare and Social Security taxes are withheld from such income. Self-employed persons shall provide proof of payment of Medicare and Social Security taxes for income to be considered earned.
If an individual’s earnings cease, ex parte review procedures (refer to Section 0840.015.05 Pre-closing Ex Parte Review) must be followed to determine eligibility under Medical Assistance PTD rules.