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 MT 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.