New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 240 - MEDICAID ELIGIBILITY - QUALIFIED MEDICARE BENEFICIARIES (QMB) (CATEGORY 040) › Part 500 - INCOME AND RESOURCE STANDARDS › Section 8.240.500.15 - DEEMED INCOME

Current through Register Vol. 35, No. 13, July 16, 2024
A. Minor
				applicant/recipient living with parent(s): If the applicant/recipient is a
				minor who lives with a parent(s), deemed income from the parent(s) must be
				considered in accordance with Section
				8.215.500.21 NMAC,
deemed
				income
, and applicable subsections.
B. Applicant/recipient living with an
				ineligible spouse: If an applicant/recipient is living in the same household
				with an ineligible spouse, the income of the applicant/ recipient and the
				income of the ineligible spouse must be considered in accordance with the
				following paragraphs.
(1) Evaluation of
				applicant/recipient's income: The ISD caseworker determines the amount of
				income available to the applicant/recipient using only the
				applicant/recipient's own income. Allow the standard $20 disregard in
				accordance with instructions in Subsection B of Section
				8.215.500.22 NMAC of the medical
				assistance division policy manual. If the applicant/recipient has earned
				income, allow the earned income disregard as specified in Subsection C of
				Section 8.215.500.22 NMAC. From the
				combined total of the applicant/ recipient's remaining earned and unearned
				income, subtract up to the difference between one hundred percent of the
				federal income poverty level for two persons and one hundred percent of the
				federal income poverty level for one person. This is referred to as the FPL
				disregard. Compare the remaining countable income of the applicant/recipient to
				the individual income standard for the QMB program. If the
				applicant/recipient's remaining countable income is greater than the individual
				standard, they are ineligible for the QMB program. If the applicant/recipient's
				remaining countable income is less than the individual income standard, proceed
				to the following section.
(2)
				Evaluation of the ineligible spouse's gross income: The ISD caseworker
				determines the total gross earned and unearned income of the ineligible spouse.
				From this combined amount, subtract a living allowance for any ineligible minor
				dependent child(ren) of either member of the couple who live(s) in the home.
				The deductible amount of the ineligible child(ren)'s living allowance cannot
				exceed the ineligible spouse's total gross income. The amount of the living
				allowance for an ineligible child is determined by subtracting the child's
				gross income from the figure which represents the difference between one
				hundred percent of the federal income poverty level for two persons and one
				hundred percent of the federal income poverty level for one person. A "child"
				must be under 18 years of age or under 21 years of age if a full-time student
				at an institution of learning.
(3)
				Determination of countable income for eligibility purposes: The ISD caseworker
				adds the gross unearned income of the applicant/recipient (without applying any
				disregards) to the gross unearned income of the ineligible spouse. The ISD
				caseworker then adds the total gross earned income of the applicant/ recipient
				to the total gross earned income of the ineligible spouse. From the combined
				total gross earnings of the couple, the ISD caseworker subtracts one earned
				income disregard (the first $65 of the total earnings plus one half of the
				remainder). The resulting figure is the total combined countable earnings of
				the couple. Add the couple's total combined countable earned income to their
				total gross unearned income. From this figure subtract the standard $20
				disregard determined in accordance with Subsection B of Section
				8.215.500.22 NMAC. Next, subtract
				the amount of the FPL disregard which the applicant/recipient was allowed.
				Finally, subtract the amount of the ineligible child(ren)'s living allowance
				which was calculated in Paragraph (2) of Subsection B of Section
				8.240.500.14 NMAC. The resulting
				figure is the countable income of the couple. Compare it to the couple standard
				for QMB. If the countable income of the couple exceeds the couple standard, the
				applicant/recipient is ineligible for the QMB program. If the countable income
				of the couple is less than the couple standard, the applicant/ recipient is
				eligible for the QMB program of the factor of income.