2506 Medicaid Individual Budgeting

Georgia State Seal

Georgia Division of Family and Children Services
Medicaid Policy Manual

Policy Title:

Medicaid Individual Budgeting

Effective Date:

February 2020

Chapter:

2500

Policy Number:

2506

Previous Policy Number(s):

MT 6

Updated or Reviewed in MT:

MT-58

Requirements

Individual budgeting is completed when an individual residing in LA-A or B applies for or receives ABD Medicaid as a Medicaid Individual with no spouse.

Basic Considerations

An individual budget is completed for a Medicaid Individual residing in LA-A or B without a spouse whose eligibility is determined under the following classes of assistance (COAs):

  • SSI (3 months prior or intervening months)

  • Public Law Classes, including Disabled Widow(er) and Disabled Adult Child (DAC)

  • ABD Medically Needy (AMN)

  • QMB

  • SLMB

  • QI-1

  • QDWI

Procedures

Enter the appropriate information in the computer system to allow the system to budget correctly,

OR

Follow the procedures below to manually complete an Individual budget on Form 172:

Step 1

Complete Section A of Form 172.

  • Include the income of the Medicaid individual in Section A.

  • Use the Individual income limit for the COA under which the Medicaid individual is applying.

Step 2

If there is a deficit on Line 13 of Section A, the Medicaid individual is eligible under this COA based on income.

Step 3

If there is a surplus or zero on Line 13 of Section A, the Medicaid individual is ineligible under this COA. Complete a CMD. Refer to 2052 Continuing Medicaid Determination.

If the individual is applying for QMB and there is a zero on Line 13, the individual is eligible for QMB based on income.
If the individual is being budgeted under AMN and there is a surplus on Line 13, use the amount from Line 13 as the AMN spenddown.