2499 Treatment of Income in Medical Assistance | Medicaid

Unearned - the value of accident or health plan coverage provided by an employer.

E

Long Term Care Coverage - contributions by an employer to provide coverage for long-term services. This includes Archer MSA contributions.

E

Health Flexible Spending Arrangement (health FSA) - employer provided health FSA which will result in a reduction of salary and reimbursements of medical care.

E

Health Savings Accounts (HSA) - contributions made by the individual are deductions for tax returns.

E

Distributions from HSA that are used to pay medical expenses.

E

Distribution from HSA that are not used to pay medical expenses.

E

Contributions to HSA made by employers

I

Qualified HSA funding distribution-a onetime distribution from an individual retirement account (IRS) to an HAS.

E

Unearned – Payment received for the adoption of certain children.

IV-E - Exclude as income.

E

IV-B - Exclude as income.

E

Unearned – Money for future expenses that does not represent a gain to the AU.

E

Earned – A prepayment of wages or salaries.

I

AGENT ORANGE PAYMENTS

Unearned – A payment made to a Vietnam Veteran who was exposed to Agent Orange defoliant. The payment is made to the surviving spouse and children.

E

Unearned – Payments made under Alaska Native Claims Settlement Act.

E

Alaska Permanent Fund Dividend-payment from Alaska’s mineral income fund.

I

ALIMONY / SPOUSAL SUPPORT

Unearned – A court-ordered payment from an estranged spouse or former spouse to the other spouse for support under the terms of a court order or settlement agreement following a divorce. Payments may be in one lump sum, or in a series of monthly payments. Alimony is also termed “spousal support” or “maintenance”.

I (ABD and Non MAGI FM)

E* (MAGI)

*Divorces and separations finalized before 01/01/2019 consider Alimony as income for MAGI.

Living Allowance Stipend – Earned Income

E (ABD and Non MAGI FM)

I (MAGI)

On-the Job Training – Earned Income

E (ABD and Non MAGI FM)

I (MAGI)

ANNUITY

Unearned – Recurring payment received from an investment. Refer to 2339 Annuities.

I

ASSISTANCE BASED ON NEED (ABON)

Unearned – assistance provided under a program which uses income as a factor of eligibility and is funded wholly by a state or local government.

E

BLACK LUNG BENEFITS

Unearned – benefits paid to miners and their survivors under the provisions of the Federal Mine Safety and Health Act. Phone number for United Mine Workers is 1-800-654-9763.

I (ABD and Non MAGI FM)

E (MAGI)

BLOOD, sale of

Earned – Money received from the sale of blood including blood products.

I

BOARDER INCOME

Earned – Direct payments for food and related shelter expenses, less the cost of doing business.

I

BONUS

Earned – Wages paid in addition to the usual or expected wages. Refer to Wages in this chart.

I

CAPITAL GAINS

Earned or Unearned – profits from the sale of capital goods or equipment.

Capital assets are resources such as stock, securities, real estate and equipment that are typically held as an investment for a period of time. A capital gain is realized when the item(s) sold have appreciated in value from the original purchase price.

I

CENSUS INCOME

Earned - All wages paid by the Census Bureau for temporary employment related to Census activities.

E (ABD and Non MAGI FM)

I* (MAGI)

*As of 01/01/2019

CHARITABLE DONATION FROM PRIVATE NON-PROFIT ORGANIZATION NOT STATE / FEDERALLY FUNDED

Unearned – Charitable donation paid to the AU or BG.

E

CHARITABLE DONATION FROM FEDERALLY OR STATE FUNDED ORGANIZATION

Unearned – Charitable donation paid to the AU or BG from organizations receiving state or federal funds. For example: Salvation Army, United Way, Catholic Charities, and Lutheran Social Service Agencies.

I

CHILD CARE ATTENDENT (wages earned by)

I

CHILD CARE PAYMENTS

Unearned – Payments made under Title IV of the Social Security Act to a child care provider on behalf of the AU. These payments include Transitional Child Care, and At Risk block grant child care payments made under P.L 101-508, Section 5801 of the Social Security Act.

E

CHILD NUTRITION PAYMENTS

Unearned – The value of meals provided to a child in day care through the Child Nutrition Amendment of 1978.

*If the payment is for a child of the attendant, budget the entire amount as unearned income.

If the payment is for any other child, treat as self-employment income. Refer to the Section 2415, Self Employment.

*I

CHILD SUPPORT

Unearned – Income received for the support of child (ren) from the non-custodial parent of the child. Child support paid for a child by a non-custodial parent is always income to the child and never to a parent/ relative/ guardian.

*If an ABD child (including LA-D A/Rs) receives child support from a non-custodial parent exclude from the eligibility budget 1/3 of the monthly child support received.

I* (ABD)

I (Non MAGI FM )

E (MAGI)

CHILD’S EARNINGS

Children in Placement

Earned – Income earned by a child, including MAGI Medical Assistance under 19 years old and for CW-FC children to 21 years.

*Refer to Section 2610 to determine when Child’s Earnings should be counted.

Reference Section 2835, PROCEDURES, Earnings of an AFDC Child, for exclusion criteria for children in care.

I (ABD)

E* (MAGI and Non MAGI FM)

CIVIL SERVICE AND FEDERAL EMPLOYEE RETIREMENT SYSTEM BENEFITS

I

COMMISSION

Earned – A payment, usually a set fee or percentage, made to an employee for his/her service in facilitating a transaction such as buying or selling goods. A commission may be paid in lieu of or in addition to a regular salary. Refer to Wages in this chart.

If the payment is recurring, include it when determining representative pay. If not, do not include the pay. Refer to Section 2653, Prospective Budgeting.

I

CONTRACTED EMPLOYMENT INCOME

Earned – Income received from jobs in which there is a contract or payment agreement. Determine the gross monthly amount by dividing the total amount during the life of the contract by the number of months specified in the contract.

I

CONTRIBUTION, GIFT, PRIZE, AWARD

*I (ABD)

I (Non-MAGI FM)

E (MAGI)

DEATH BENEFITS

*I

DEEMED INCOME

Unearned – A portion of income of a non-AU or BG member that is applied to the AU.

*For ABD, there is no deeming in Patient Liability/Cost Share determinations.

I

DEFERRED COMPENSATION PLAN

UNEARNED - Money paid regularly from a deferred compensation plan. The money is usually available upon the owner’s employment retirement or if the owner attains a certain age.

I

DISABILITY

Unearned – Paid by insurance company or a source other than an employer. Refer to Sick Pay in this chart.

E (MAGI)

I (ABD and Non-MAGI FM)

DISASTER ASSISTANCE (Presidentially Declared)

Unearned – Government payments for restoration of a home damaged by a disaster.

E

DISASTER UNEMPLOYMENT ASSISTANCE

UNEARNED - Unemployment benefits paid to an AU member during a major disaster or catastrophe.

E (ABD and Non MAGI FM)

I (MAGI)

Unearned – Money deducted or diverted by a court order to a third party.

E

Unearned – Money that is legally obligated to an AU member by a court order but is diverted at the option of the AU member to a third party.

I

Benefits/support (child support, SSI, RSDI, etc.) of a child in care diverted to the county of custody as designated payee for the benefit and care of the child and are considered the child’s benefits/support. Refer to specific type of income for treatment of income.

Unearned - Income diverted to a spouse or dependent family member from a NH or CCSP A/R.

Include as unearned income to the spouse or dependent family member (DFM) to whom the income is diverted in the eligibility and CCSP/ICWP cost share budgets, if the spouse/DFM is a Medical Assistance A/R. Refer to Section 2554, Diversion of Income.

I

I

DIVIDENDS

*E

DOMESTIC VOLUNTEER SERVICES PAYMENTS

Unearned – Payments to volunteers under the federal government program

E

EARNED INCOME TAX CREDIT (EITC)

Unearned – A special tax credit which reduces the federal tax liability of certain low income working taxpayers. This tax credit may or may not result in a payment.

EITC payments can be received as an advance from an employer or a refund from IRS.

EITC given as a tax credit (no payment) is not income.

E

EDUCATIONAL GRANTS, SCHOLARSHIPS AND LOANS

(Title IV of Higher Education Act Programs)

UNEARNED - Payments for the educational assistance of an AU member enrolled at a recognized institution of post-secondary education, school for the handicapped, vocational program or a program that provides for completion of a secondary school diploma or GED. These programs include Pell grants, State Student Incentive Scholarships, Work-Study programs, etc.

Unearned – payments from educational assistance to the A/R. Exclude, regardless of use.

E

EMERGENCY ASSISTANCE (IV-A)

I

EMPLOYEE RETIREMENT BENEFITS

Unearned – Individuals/surviving spouse may be eligible for retirement benefits based on previous employment.

Explore if the A/R or spouse worked 10 or more years for the same employer.

I

ENERGY ASSISTANCE PAYMENTS

Unearned – Payment or allowance received under federal, state, and local law for the purpose of assisting the AU with the cost of heating and cooling its home. These include HUD and FMHA Utility reimbursements.

E

FARM ALLOTMENTS

Unearned – Payments from government sponsored programs such as Agricultural Stabilization and Conservation Services which are a gain or a benefit to the AU.

I

FARMING

Earned – Income received from agricultural labor. Refer to Section 2415, Self Employment.

I

FEDERAL EMERGENCY MANAGEMENT AGENCY (FEMA) EMERGENCY FOOD DISTRIBUTION AND SHELTER PROGRAMS

Unearned – food and shelter assistance provided in cash or in kind in emergency disaster situations.

Exclude if the assistance is designated as home energy assistance or support and maintenance assistance.

Otherwise, contact the State Medicaid Policy Unit for further instructions.

E

FEDERAL PROGRAMS, MISCELLANEOUS

E

FLEXIBLE BENEFITS

Earned – Refer to Wages in this chart.

I

FOSTER CARE PAYMENTS (IV-B or Title XX)

Unearned – per diem payments received by the foster parents to provide for the needs of the foster child and foster family.

E

FOSTER CARE PAYMENTS (IV-E)

Unearned – per diem payment received to provide for the needs of the foster child.

Exclude as income to the foster child.

E

FOSTER GRANDPARENTS PROGRAM PAYMENTS

Unearned – payments received for voluntary service under the federal government (ACTION)

E

GARNISHMENT

Earned/Unearned – A set amount of wages or monies withheld by an employer/entity to pay a debt owed to a third party.

I

GUARDIANSHIP, ENHANCED SUBSIDIZED AND SUBSIDIZED

Financial support for a child who was in the custody of DHR and guardianship is awarded to a relative or non-relative foster parent(s). Income is not attributed to the child. Reference Section 2848 – Relative Care Placement for additional information.

E

GENERAL ASSISTANCE (GA) PAYMENTS

Unearned – payments received by the A/R from county funds administered by DFCS. Consider as Assistance Based on Need (ABON).

E

GENERAL ASSISTANCE VENDOR PAYMENTS

Unearned – GA paid directly to the provider if paid for housing expenses including GA paid for transitional housing for the homeless and if paid for energy or utilities.

E

GRANDPARENTS RAISING GRANDCHILD - REN EMERGENCY / CRISIS INTERVENTION SERVICES

TANF lump sum payment in the amount of three times the eligible grant amount for the AU size.

This payment is used to help pay for the cost of emergent needs incurred by the grandparents when the children come to live with them.

*For ABD, do not deem GRG income of the A/R’s parent or spouse to the A/R.

I* (ABD)

E (MAGI and Non MAGI FM)

GRANDPARENTS RAISING GRANDCHILD - REN SUBSIDY PAYMENT

UNEARNED - TANF Subsidy in the amount of $50.00 per child per month used assist low income (fixed income) grandparents (60+) to cover additional expenses associated with rearing their grandchildren.

*For ABD, do not deem GRG income of the A/R’s parent or spouse to the A/R.

I* (ABD)

E (MAGI and Non MAGI FM)

GRANDPARENT PAYEE

*The Grandparent payee’s income is not counted in the TANF budget. The children’s TANF income is not counted in the Grandparent Payee’s ABD budget

*

HEALTH REIMBURSEMENT ACCOUNT

An account through an employer which may only be used to reimburse individuals for certain medical services.

*Count any income received in excess of the incurred expense(s) as unearned income.

*E

HOME PRODUCE

Unearned – home produce used for personal consumption and not offered for sale.

E

HOUSING AND DEVELOPMENT (HUD) RENTAL REFUND

Unearned – Payment received by the AU for rent. Payments are often distributed by the Georgia Residential Financial Authority (GRFA).

Payments can be made directly to the AU, by a two-party check or directly to the landlord on behalf of the AU.

E

HOUSING AND URBAN DEVELOPMENT (HUD) OR FARMERS HOME ADMINISTRATION (FMHA) UTILITY REIMBURSEMENT

Unearned – Utility reimbursement provided by HUD and FMHA to AUs who receive housing assistance and are responsible for paying their utilities separately from their rent.

Payments can be paid directly to the AU, by a two-party check or directly to the utility company on behalf of the AU.

E

INCOME BASED ON NEED (IBON)

Unearned – Assistance provided under a program that considers other income as a factor in determining eligibility and is funded wholly or partially by the federal government or a non-governmental agency for the purpose of meeting basic needs (TANF, SSI, VA Pension, etc.).

NOTE FOR ABD: Do not allow the $20 general exclusion to IBON. Do not deem IBON received by the A/R’s spouse or parent to the A/R.

See specific type of IBON

See specific type of IBON

INCOME TAX REFUND

*Refer to the Chapter 2300, Resources, to determine how to count income tax refunds. For how to count in PL/CS, refer to Section 2552, PL/CS Deductions.

*

INDIAN LAND GRANTS

Unearned – Federal distributions to members of Indian Tribes.

E

INDIAN GAMBLING ACT PAYMENTS

Tribally managed gaming revenues

*If the funds have NOT been held in trust by the Secretary of the Interior, count as unearned income. If held in trust by the Sec. of Interior, exclude.

*

INHERITANCE

I

IN-KIND ITEMS RECEIVED IN LIEU OF WAGES

Earned – Wages may include the value of food, clothing, shelter or other items provided in lieu of cash wages.

I (ABD)

E (MAGI and Non MAGI FM)

IN-KIND SUPPORT AND MAINTENANCE

Unearned – Any gain or benefit that is not in the form of money payable directly to the AU such as meals, clothing, produce or housing.

*Refer to Section 2430, Living Arrangements and In-Kind Support and Maintenance.

*I (ABD)

E (MAGI and Non MAGI FM)

INSURANCE BENEFITS DUE TO LOSS OF INCOME

Unearned – benefits paid from an insurance policy due to loss of income.

*Refer to Section 2230, Third Party Resources, for information on benefits paid to cover medical expenses.

*I

INTEREST

*I (MAGI and Non MAGI FM)

*E (ABD)

Exclude interest earned on the excluded portion of a burial contract for FBR A/Rs.

E

Exclude all interest earned on a burial contract for non-FBR A/Rs if left to accrue.

E

Exclude interest earned on the excluded portion of funds set aside for burial for FBR A/Rs.

E

Exclude interest earned on the first $5000 of funds set aside for burial for non-FBR A/Rs if left to accrue.

E

Exclude interest earned on the dividend accumulations from excluded life insurance policies for ABD non-FBR A/Rs.

E

For Family, include interest earned on life insurance policies, stocks and mutual funds.

I

For ABD, exclude as income dividends/interest earned on countable resources such as stocks and mutual funds.

E

Earned and Unearned – Income that is received too infrequently or irregularly to be anticipated, regardless of the amount. Refer to Section 2504 for definition of irregular or infrequent income. Treat such income as the following:

Earned income of $30 or more received over a three month period

I

Earned income of less than $30 received over a three month period

E (ABD)

I (MAGI and Non MAGI FM)

Unearned income of less than $60 received over a three month period

E (ABD)

I (MAGI and Non MAGI FM)

Unearned income of $60 or more received over a three month period

I

JAPANESE – AMERICAN AND ALEUTIAN RESTITUTION PAYMENTS (PL 100-383)

Unearned – Restitution payments made by the U.S. Government to Japanese-Americans and Aleutians or their survivors as a consequence of their evacuation, relocation and internment during World War II.

E

JURY DUTY

Earned – Compensation received for serving on a jury.

I

LOANS FROM OTHERS (PERSONAL OR BUSINESS): A/R is making payments

Unearned – Money received that the borrower has an obligation to repay. Requires a prepayment agreement (written or oral).

E

LOANS TO OTHERS

(Payment made to A/R)

Unearned - Money loaned to persons outside the AU where a repayment agreement exists.

Payments received are considered income.

*ABD refer to Section 2313.

I*

LOTTERY WINNINGS

Unearned – A sum of money received as a result of purchasing a winning ticket in a game of chance.

*Refer to the appropriate sections on Lump Sum budgeting for Family or ABD Medical Assistance and also refer to note in Section 2405.

*

LUMP SUM

Children in Placement

Unearned – A sum of money that is received at one time. This may be an accumulated amount or a one-time occurrence.

*Count as income in month of receipt. Any remainder is counted as a resource beginning the month after receipt (refer to Resources Chart 2399.1, Lump Sums).

For all AFDC related categories of Medical Assistance, a lump sum is treated as income in the month received and as a resource in any amounts thereafter.

*

Unearned – Money legally due the AU that is paid to a protective payee even if the payee is not a member of the AU or resides elsewhere.

I (ABD)

I (MAGI and Non MAGI FM)

I (ABD)

I (MAGI and Non MAGI FM)

MILITARY ALLOTMENTS

Unearned – payments received for quarters, rations, and clothing are subject to deeming.

In ABD, Furnished on-post housing is subject to the PMV rule as ISM but is not subject to deeming.

*In Family, consider the income as child support if for a dependent child. Only base pay is earned income. (This would be excluded for MAGI COAs)

I

MILITARY PAY

Military personnel benefits as reported on Leave and Earnings Statement (LES). Refer to Section 2420, Military Pay.

I

MILITARY RETIREMENT

I

MILITARY RETIREMENT LUMP SUM

Unearned – Consider as unearned income in the month or receipt. Treat as a resource the month following the month of receipt.

I

MONTGOMERY GI BILL PAYMENTS

E

NATIONAL EMERGENCY GRANT (DISASTER RELIEF EMPLOYMENT)

UNEARNED - Grants funded by FEMA, used to provide disaster relief employment on projects that provide food, clothing, shelter and other humanitarian assistance for disaster victims.

E

NATIONAL FLOOD INSURANCE PAYMENTS

UNEARNED - Payments made for flood mitigation activities under the National Flood Insurance Act of 1968.

E

NOISE ABATEMENT PAYMENTS

Unearned – Non-recurring payment designated for noise abatement work on a dwelling.

E

OLDER AMERICANS ACT / SENIOR COMMUNITY SERVICE EMPLOYMENT PROGRAM

Earned – Title V income paid for community service employment to individuals 55 or over. This includes Green Thumb income. Anything provided under these programs other than a wage or salary is excluded income.

I (ABD)

E (MAGI and Non MAGI FM)

OVERTIME PAY

EARNED - Extra income paid to employees who work in excess of 40 hours in a week. Refer to Wages in this chart.

I

PENSIONS

Unearned – A payment received regularly as a retirement benefit.

I

PUBLIC LAW 103-286 - PAYMENTS to VICTIMS of NAZI PERSECUTION

(examples, including but not limited to the following: German Reparation, German Pensions for Work in Ghettos

Unearned – any payments made to individuals because of their status as victims of Nazi persecution under Section 1(a) of the Victims of Nazi Persecution Act of 1994, Public Law 103-286 Such payments are disregarded in determining eligibility for any amount of benefits/services provided under any Federal or federally assisted program based on need.

E

Qualified Income Trust (QIT)

Income placed in a QIT allows for income eligibility under ABD LA-D COAs. Refer to Section 2407.

MAGI and Non MAGI FM – N/A

ABD LA-D COAs – E

All other ABD COAs – N/A

Qualified Tuition Savings Programs (529 Plans)

A savings plan for higher education. Refer to Section 2344.

E

RAILROAD RETIREMENT (RR)

Unearned – retirement, survivors or disability income paid to former railroad employees and/or their dependents.

Use gross RR and/or RSDI, including the amount paid as a Medicare premium.

*For ABD, refer to Section 2552, Patient Liability/Cost Share Deductions, for information on allowing the Medicare premium as a deduction in the patient liability/cost share budget.

Consider a benefit augmented for dependents as income to the beneficiary, not the dependent.

If the A/R’s SSN begins with a 7, the individual is likely to be eligible for RR.

If the A/R’s deceased spouse worked for a railway system, the A/R may be eligible, even if remarried.

RSDI and RR may be combined in one check. If so, verify RSDI via SSA and RR through the Railroad Retirement Board.

To obtain written verification of the benefit amount, complete Form 990 and mail to:

[%hardbreaks] Benefits Verification Railroad Retirement Board 401 W. Peachtree Street, Room 1702 Atlanta, GA 30365-2550

I

REFUNDS FROM DCH

Unearned – A refund of excess proceeds from a TPL after Medicaid and the TPL have paid a medical expense claim in full.

I

REIMBURSEMENT

Unearned - Payment for an expense that does not represent a gain or benefit to the AU.

E

RELATIVE CARE SUBSIDY

Unearned - Financial support for children placed with an approved relative caregiver.

A child may or may not be in DFCS custody for relative caregiver to qualify for certain subsidies.

E

RELOCATION ASSISTANCE

Unearned – Money paid under Title II of the Uniform Relocation Assistance & Real Property Acquisition Policies Act of l970.

E

RENTAL INCOME

Earned or unearned – Money received on property owned by an AU member and rented to others.

Earned – Must be engaged in management of property an average of 20 hours per week.

Unearned – If not involved in management more than 20 hours per week.

I

Family - May deduct expenses from maintaining and handling of property

REPAYMENT OF OVERPAYMENT OF BENEFITS THROUGH BENEFIT REDUCTION IN TANF, SSI, RSDI, UCB (or others)

FAMILY: Unearned – Money withheld from the income source to repay a previous overpayment.

Do not count the repayment amount. Count the gross minus the repayment amount.

*ABD: Refer to RSDI Recoupment Amount and SSI Recoupment Amount in this chart.

E (MAGI and Non MAGIFM)

ABD - *

RETIRED SENIOR VOLUNTEER PROGRAM (RSVP)

Unearned – A federal volunteer services program.

E

RETIREMENT

Unearned – A sum of money paid regularly as a retirement benefit.

I

RETIREMENT SURVIVORS DISABILITY INSURANCE (RSDI) (Also referred to as TITLE II BENEFITS or Social Security Benefits)

I (ABD and Non-MAGI FM)

I* (MAGI)

Unearned – allows a homeowner to borrow, via a mortgage contract, a portion of the appraised value of the home. The homeowner then receives a periodic payment (or a line of credit) which does not have to be repaid as long as the borrower lives in the home. Reverse Annuity Mortgages (RAMs) involve the purchase of an annuity. In most reverse mortgages, the original loan does not need to be repaid until the homeowner dies, sells the home, or moves.

The HEC plans connected with HUD through the Federal Housing Authority are reverse mortgages.

Treat as loan proceeds

I

Annuity payments from a RAM

E

ROOMER

Earned – Direct payments for room only.

I

RSDI RECOUPMENT AMOUNT

Unearned – an amount withheld from an individual’s monthly RSDI check by SSA to recover an overpayment of RSDI benefits to the individual

*Refer to Repayment of Overpayment of Benefits on Page 2499-22.

I (ABD)

E* (MAGI and Non MAGI FM)

Unearned – the homeowner transfers title of the home to a buyer (e.g., an individual or financial institution) in exchange for an installment note satisfied by monthly payments. The installment note may bear interest. The buyer, in turn allows the former homeowner to remain in the home for life (or until the arrangement is terminated) in exchange for rent. The difference between payments on the installment note and the rental cost provides the former homeowner with cash. Under this arrangement, the buyer is responsible for the payment or real estate taxes, major maintenance, and casualty insurance. Some sale-leaseback arrangements involve the purchase of an annuity.

Treat as the conversion of a resource, not as income.

E

Interest earned from an installment note

I

Annuity payments

I

SCHOOL LUNCH PROGRAM

UNEARNED - The cash value of assistance provided to children under the National School Lunch Program, Child Nutrition Act, Special Milk Program, or School Breakfast program.

E

SELF EMPLOYMENT EARNINGS (NET)

Earned – income from a self-employed enterprise.

Refer to 2415 Self-Employment.

I

SENIOR COMPANION PROGRAM

Unearned – payments to volunteers under a federal government program

E

SEVERANCE PAY

Earned – Money received from former employer upon termination of employment.

Unearned - payments received from a former employer after termination of employment.

I

SHARED HOUSEHOLD EXPENSES

Payments made to an AU by a person who shares household expenses, and which do not represent a gain or benefit to the AU.

Consider UNEARNED income for Family Medical Assistance.

Refer to 2430 Living Arrangement and In-Kind Support and Maintenance for ABD Medicaid.

E

SHELTERED WORKSHOP / WORK ACTIVITY CENTER PAYMENTS

Earned – payments received for work performed in a sheltered workshop or work activity center.

I

Sick Pay is a payment made to or on behalf of an employee by an employer or a private third party for sickness or accident disability.

I

Unearned – Any payments for sickness and accident disability paid more than 6 months after work stopped because of sickness or disability or sick payments made from the employee’s own contributions are unearned income.

I

Earned – If paid from employer’s payroll.

I

Unearned – Paid by insurance company or a source other than an employer.

E (MAGI)

I (ABD and Non-MAGI FM)

SPECIAL AND DEMONSTRATION VOLUNTEER PROGRAMS

Unearned – Payments to volunteers under a federal government program

E

SPENDING ACCOUNT

EARNED - Pre-taxed earnings that are deducted from an employee’s gross wages and placed in an account to pay AU expenses such as childcare and medical costs.

I

STRIKE BENEFITS

Unearned – Income received by individuals on strike.

I

SUPPLEMENTAL SECURITY INCOME (SSI)

Unearned – monthly payments made to aged, blind or disabled individuals from the federal government. SSI is administered by the Social Security Administration. Consider as Income Based on Need (IBON). SSI recipients also receive Medical Assistance.

*For ABD, do not deem the ineligible parent or spouse’s SSI income to the A/R. However, include SSI in the Couple eligibility budget when one member of the couple is AMN and the other receives SSI.

**Refer to 2578 SSI Recipients for information on including SSI income in nursing home patient liability budgets.

*I (ABD)

E (MAGI and Non MAGI FM)

SSI RECOUPMENT AMOUNT

Unearned – an amount withheld from an individual’s monthly SSI or RSDI check by SSA to recover an overpayment of SSI benefits to the individual.

*Exclude a SSI recoupment from a SSI check, but include a SSI recoupment from an RSDI check, in the patient liability budget.

For Family Medical Assistance, refer to Repayment of Overpayment of Benefits through Benefit Reduction in TANF, SSI, RSDI, UCB or others on page 2499-22-23.

I (ABD)

E (MAGI and Non MAGI FM)

SUSAN WALKER VS BAYER CORPORATION SETTLEMENT PAYMENTS

A cash settlement as a result of a class action lawsuit.

Unearned

E

A refund of taxes paid on food, income or property. It may be considered as earned or unearned.

E

Earned - A refund of federal or state taxes paid on income.

E

Unearned - A refund of taxes paid on food or property, such as real property or automobiles. Refer to 2405 Treatment of Income.

*Refer to 2552 Patient Liability/Cost Share Deductions.

E

TEMPORARY ASSISTANCE FOR NEEDY FAMILIES (TANF)

Unearned – benefits received from Temporary Assistance to Needy Families, including supplemental payments.

TANF benefits received from another state are budgeted for the month of receipt only.

*For ABD, do not deem TANF income of the A/R’s parent or spouse to the A/R.

I* (ABD)

E (MAGI and Non MAGI FM)

TIPS

Earned – Voluntary payments above the stated cost of a product or service given in appreciation for the service rendered. Refer to Wages in this chart.

I

TRADE READJUSTMENT ALLOWANCE (TRA)

UNEARNED - Weekly payment available for up to 52 weeks after an individual’s UCB is exhausted and during a period in which the individual is participating in a full-time training program approved in accordance with the Trade Act.

I

TRAINING ALLOWANCES / STIPENDS

(Refer to WIA for treatment of WIA income)

I

TRANSITIONAL SUPPORT SERVICES (TANF)

UNEARNED - TANF support payment used to pay for or reimburse the cost of childcare, transportation, and incidental expenses to an applicant or recipient. TSS is available for a period of six months beginning with the first month of TANF ineligibility.

*For ABD, do not deem WSP income of the A/R’s parent or spouse to the A/R.

I* (ABD)

E (MAGI and Non MAGI FM)

Unearned – Money in a trust fund.

*If the trust is not a Medicaid Qualifying Trust (MQT), include as income only those trust proceeds actually provided to the A/R by the trustee.

*I

*If the trust is an MQT, refer to 2336 Trust Property, Medicaid Qualifying (Prior to OBRA ’93) for information on how to treat the trust proceeds.

Verify by a copy of the trust document and contact with the trustee.

*I

UNEMPLOYMENT COMPENSATION BENEFITS (UCB)

Unearned – Benefits received from the Department of Labor (DOL) by unemployed individuals. Usually received weekly.

Continue to count until notified by the A/R of termination. Use DOL Clearinghouse for verification of the amount and date of weekly benefits.

I

UNION FUNDS

Unearned – Refer to Strike Benefits in this chart.

I

UNIVERSITY YEAR FOR ACTION (UYA)

Unearned – payments received under a federal volunteer services program.

E

UTILITY PAYMENT (HUD SECTION 8/GRFA/FMHA)

Unearned - *Refer to Housing and Development (HUD) in this chart.

*

VACATION PAY

Earned – Any amount paid to employees for a regular scheduled period spent away from work or regular duty. It includes amounts paid even if the employee chooses not to take a vacation. Refer to Wages in this chart.

I

UNEARNED - Money paid by an outside source to a third party on behalf of the AU for an expense.

E

Personal expenses paid for by another person that does not make up for a loss caused by that person.

E

Personal expenses paid for by another person that makes up for a loss caused by that person, and only restores the individual to a position before the loss.

I

E

VETERANS ADMINISTRATION (VA) BENEFITS

Refer to 2418 VA Income for a description of the different types of VA income.

VA PENSION

Unearned

VA pensions are IBON and are not entitled to the $20 general exclusion. (Section 2505)

I (ABD)

E (MAGI and Non MAGI FM)

VA COMPENSATION

I (ABD)

E (MAGI and Non MAGI FM)

VA EDUCATIONAL BENEFITS

Unearned

I (ABD)

E (MAGI and Non MAGI FM)

Aid and Attendance

E

Unusual Medical Expense (UME) reimbursement & Continuing Medical Expense (CME)

E

Housebound Allowance

E

Clothing Allowance

E

Augmented VA Benefits

*I (ABD)

E (MAGI and Non MAGI FM)

Augmented VA Benefits To NH/CCSP A/Rs

*I (ABD)

E (MAGI and Non MAGI FM)

VA Recoupment

Repayment of VA benefits which are deducted from the VA check.

I

Count the gross amount for eligibility determination

FM-E

VA Lump Sum

Unearned

*Any portion of a VA lump sum that is not VA Aid and Attendance, is not VA UME reimbursement or is not augmented is counted as unearned income for the month of receipt.

*I (ABD)

E (MAGI and Non MAGI FM)

Unearned – Money received by a victim of a crime from a crime victim restitution program, usually a reimbursement for financial losses.

E

The value of the payment does not exceed the value of the loss

E

The value of the payment exceeds the value of the loss. Count the excess value as income in the month of receipt.

I

The payment is a set monthly amount based on a court ruling. Count as income in the month of receipt.

I

VISTA VOLUNTEER PAYMENT

Earned – Income received by VISTA volunteers under Title I of the Domestic Volunteer Services Act. Included are payments from the Urban Crime Prevention Program

E

Unearned – Title II of Domestic Volunteer Services Act of l973

E

Unearned – Payments from Title I. Exclude only if the A/R was receiving FS or AFDC at the time they joined Title I even if there is a break in participation.

E

WAGES (SALARIES)

Children in Placement

Earned – Payment given in return for labor, goods, and services rendered. Wages may be paid on an hourly, weekly, or daily basis.

Include commissions, tips, overtime, vacation pay, bonus pay, flex benefits, and the employee’s share of FICA when paid by the employer.

Reference 2835 AFDC Relatedness Budgeting, PROCEDURES, Earnings of an AFDC Child, for exclusion criteria.

I

WORKER’S COMPENSATION

Unearned – payments awarded to injured employees or to their survivors. Exclude any portion designated for medical, legal, or related expenses paid or deducted and not controlled by the A/R in connection with claim.

Verify from the employer or from the source of the payment.

I (ABD)

E (MAGI and Non MAGI FM)

WORKFORCE INVESTMENT ACT

Earned – Income received while working as part of a WIA program.

I

WORK STUDY PROGRAM (Federal)

Earned – A plan operated by a post or secondary school during the school year in which a student works on campus and earns money.

E

WORK STUDY PROGRAM (Non-Federal)

Earned – A plan operated by a post or secondary school during the school year in which a student works on campus and earns money.

I

YOUTH BUILD PROGRAM PAYMENTS

EARNED - Payments made through the Youth Build Program.

*See WIA for treatment of this income.

I*

YOUTH PROJECT PAYMENTS

I*