405 IAC 2-1.1-7 - Posteligibility treatment of income
Authority: IC 12-13-7-3; IC 12-15
Affected: IC 12-15-7-2
Sec. 7.
(a) This
section applies to individuals who are determined eligible under section 5(g)
of this rule who are either residing in an institution or are receiving home
and community based waiver services.
(b) Except as provided in
405
IAC 2-3-17, the following procedure shall be used to
determine the amount of income to be paid to an institution for an applicant or
member who has been determined eligible under section 5(g) of this rule and who
is residing in an institution as defined in
405 IAC 2-1-1(4)
or receiving home and community based waiver
services:
(1) Determine the applicant's or
member's total income that is not excluded by federal statute, which includes
amounts deducted in the eligibility determination under section 5(g)(3) of this
rule.
(2) Subtract the minimum
personal needs allowance equal to either of the following amounts:
(A) Specified in IC
12-15-7-2
for an individual residing in an institution.
(B) The special income level for an
individual receiving home and community based waiver services.
(3) Subtract an amount for
increased personal needs as allowed under Indiana's approved Medicaid state
plan. The increased personal needs allowance includes, but is not limited to,
court ordered guardianship fees paid to an institutionalized applicant or
member's legal guardian, not to exceed thirty-five dollars ($35) per month.
Guardianship fees include all services and expenses required to perform the
duties of a guardian, as well as any attorney's fees for which the guardian is
liable.
(4) Subtract the amount of
any health insurance premiums.
(5)
Subtract an amount for expenses incurred for necessary or remedial care
recognized by state law but not covered under the state plan, subject to any
reasonable limits set forth in Indiana's approved Medicaid state
plan.
(6) Subtract an amount for
federal, state, and local taxes owed and paid by the applicant or member. This
deduction is limited to one (1) calendar month per year.
The resulting amount is the amount by which the Medicaid payment to the institution where the individual resides, or to other Medicaid approved providers, when the individual is receiving home and community based waiver services, shall be reduced.
(c) A child under eighteen (18) years of age
determined eligible for benefits under section 5(g) of this rule will not have
any resources or income from his or her parents deemed to such child under this
section.
Notes
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
No prior version found.