Spend Down (includes disabled child) – MHNS, MHSD, MHDC

1 person – aged or disabled

$913

04-01-21

$5,035

07-01-21

2 people – aged or disabled

$1,234

04-01-21

$10,070

07-01-21

1 person – blind

$1,074

04-01-21

$5,035

07-01-21

2 people – blind

$1,452

04-01-21

$10,070

07-01-21

SGA (Substantial Gainful Activity) – aged or disabled

$1,310

01-01-21

SGA – blind

$2,190

01-01-21

SSI (Supplemental Security Income)

1 person in own household

$794

01-01-21

2 people in own household

$1,191

01-01-21

1 person in another’s household

$529

01-01-21

2 people in another’s household

$794

01-01-21

SSI essential person in own household

$397

01-01-21

SSI 1619 (a) and (b)

$3,693

01-01-21

$2,000 individual

$3,000 couple

Qualified Medicare Beneficiary (QMB)

1 person

$1,074

04-01-21

$7,970

01-01-21

2 people

$1,452

04-01-21

$11,960

01-01-21

3 People

$1,830

04-01-21

$11,960

01-01-21

Specified Low-Income Medicare Beneficiary 1 (SLMB or SLMB1)

1 person

$1,288

04-01-21

$7,970

01-01-21

2 people

$1,742

04-01-21

$11,960

01-01-21

3 people

$2,196

04-01-21

$11,960

01-01-21

Specified Low-Income Medicare Beneficiary 2 (SLMB2 or QI-1)

1 person

$1,449

04-01-21

$7,970

01-01-21

2 people

$1,960

04-01-21

$11,960

01-01-21

3 people

$2,471

04-01-21

$11,960

01-01-21

Blind Pension (BP)

$7,259

(sighted spouse)

04-01-21

$29,999

2018

Supplemental Aid to the Blind (SAB) consolidated standard

$857

01-01-21

$5,035 individual

$10,070 couple

07-01-21

Qualified Disabled and Working Individuals (QDWI)

1 person

$2,147

04-01-21

$4,000

2 people

$2,903

04-01-21

$6,000

Ticket to Work Health Assurance (TWHA)

1 person

$3,220

04-01-21

$5,035

07-01-21

2 people

$4,355

04-01-21

$10,070

07-01-21

TWHA premium amounts – effective date 04-01-2019

Percent of FPL

Single or couple

Monthly income

Monthly premium

Less than or equal to 100%

Single

$1,074 or less

$0

Couple

$1,452 or less

$0

101% to 149%

Single

$1,074.01 – $1,609.99

$42

Couple

$1,452.01 – $2,177.99

$56

150% to 199%

Single

$1,610 – $2,146.99

$62

Couple

$2,178 – $2,903.99

$85

200% to 249%

Single

$2,147 – $2,683.99

$104

Couple

$2,904 – $3,629.99

$141

250% to 300%

Single

$2,684 – $3,220

$156

Couple

$3,630 – $4,355

$211

Supplementary Medical Insurance (SMI) Medicare Part B monthly premium

$148.50

01-01-21

State mileage rate (per mile)

$0.49

07-01-21

Vendor Surplus Calculation

Asset Maximum

Effective Date

All income paid to the facility as surplus minus $50 personal needs allowance and allowable deductions:

medical insurance premiums, allotments, child support

$5,035 after Division of

Assets

07-01-21

Monthly income limit for eligible individual (not including spouse)

Effective date

Asset Maximum

Effective Date

$1,388

01-01-21

$5,035 after Division of Assets

07-01-21

Spousal share – used to determine Division of Assets

Available assets

Effective Date

·        Minimum

$26,076

01-01-21

·        Maximum

$130,380

01-01-21

Allotment of income – used to determine allotments to a community spouse or dependents

Monthly amount

Effective Date

·     Minimum monthly maintenance needs allowance (MMMNA)

$2,178

07-01-21

·     Maximum MMMNA

$3,260

01-01-21

·     Maximum allocation to a child

$397

01-01-21

Shelter Expenses – used to determine allotments to a community spouse

Allowable Expense

Monthly limit

Effective Date

·     Shelter standard

$653

07-01-21

·     Utility standard

$415

10-01-21

·     Telephone standard

$67

10-01-21

Maximum home equity – For Vendor, HCB, or PACE

Asset Maximum

Effective Date

$603,000

01-01-21

Transfer of property penalty

·     Average monthly private pay nursing rate

$6,588

04-01-21

SNC income eligibility determination

Asset Maximum

Effective Date

SNC grant is available if the facility’s monthly residential care expense exceeds the participant’s countable income. The grant amount is the deficit up to the maximum monthly grant amount.

$5,035 individual

$10,070 couple

07-01-21

Grant type

Maximum monthly grant amount

Effective Date

·     Residential care facility I

$156

07-01-00

·     Residential care facility II

·     Assisted living facility

·     Intermediate or skilled without a level of care determination

$292

07-01-00

·     Intermediate or skilled with a level of care determination

$390

07-01-00

·     Personal needs allowance paid to all SNC participants

$50

01-01-15