New Jersey Administrative Code › Title 10 - HUMAN SERVICES › Chapter 71 - MEDICAID ONLY › Subchapter 5 - INCOME › Section 10:71-5.3 - Income exclusions

Current through Register Vol. 56, No. 14, July 15, 2024
(a) Only the
				following income shall be excluded in the determination of countable income.
				Income exclusions shall be applied to unearned income first, then to earned
				income as appropriate. Exclusions shall be applied in the order of their
				appearance in this section.
1. Monies
				received as a result of the sale of a resource shall be excluded. These monies
				shall be treated as a resource (see
				10:71-4.2 and
				10:71-4.4(b)8 
				ii).
2. Monies received as a result
				of the settlement of a casualty insurance claim, if such settlement is intended
				as compensation for the loss or destruction of a previously excludable
				resource, shall be excluded (see
				10:71-4.4(b)8 
				i).
3. Third-party payments for
				medical care or services, including room and board furnished during medical
				confinement, shall be excluded.
4.
				The value of social services (for example, advice, training, consultation)
				performed by any governmental or private agency shall be excluded.
5. The value of food stamps shall be
				excluded.
6. All loans which are
				actually repayable shall be excluded.
i.
				Regular contributions to an individual by his or her family, which are made
				over an extended period of time and which would be impossible to repay given
				the individual's current and/or future financial status, shall not be
				considered loans. Contributions of this nature shall be treated as income in
				accordance with
				10:71-5.2.
7. Benefits received under the following
				Federal programs shall be exempt:
i. The
				value of benefits received under the Federal WIC program shall be
				exempt.
ii. The value of meals
				provided under the National School Lunch Act shall be exempt.
iii. Training incentive payments made under
				the Comprehensive Employment Training Act (CETA) of 1973 shall be
				exempt.
iv. Payments received under
				Title II of the Uniform Relocation and Real Property Acquisition Policies Act
				of 1970 shall be exempt.
v.
				Payments received for services performed in connection with the Domestic
				Volunteer Service Act of 1973 shall be exempt. Such programs include the Foster
				Grandparents Program, Older Americans Community Service Program, the Retired
				Senior Volunteer Program (RSVP), the Service Corps of Retired Executives
				(SCORE), Volunteers in Service to America (VISTA), the Active Cooperative
				Volunteer Program (AVP), the Active Corps of Executive (ACE), and other
				programs which are coordinated by the Federal ACTION agency.
vi. Payments made by the Disaster Assistance
				Administration shall be exempt.
vii. The value of assistance to children
				under the Child Nutrition Act of 1966 shall be exempt.
viii. Payments from Home Energy Assistance
				(HEA) and the Crisis Intervention Program shall be exempt.
ix. Payments received from the Youth
				Incentive Entitlement Pilot Projects, Youth Community Conservation and
				Improvement Projects, and the Youth Employment and Training Programs under the
				Youth Employment and Demonstration Projects Act of 1978 shall be exempt.
				However, payments from the Adults Conservation Corps under that Act or any
				other payments under the Comprehensive Employment and Training Act (CETA) of
				1973 (with the exception of (a)6iii above) may not be excluded.
x. The amount of the annual cost-of-living
				increase in Social Security benefits for those individuals who became
				ineligible for Supplemental Security Income (SSI) solely as a result of SSA
				cost-of-living increases after June 30, 1977 shall be exempt. Individuals
				eligible for this exemption are entitled to an additional exemption of the
				dollar amount of all SSA cost-of-living increases subsequent to that increase
				which created their SSI ineligibility.
xi. For certain individuals, the dollar
				amount of the October 1972, 20 percent cost-of-living increase in Social
				Security benefits shall be exempt. In order to qualify for this exemption, the
				individual must have been, for the month of August 1972:
(1) Eligible for or receiving cash assistance
				under Old Age Assistance, AFDC, Aid to the Blind, or Disability Assistance
				(including persons who were eligible for such assistance but not receiving such
				assistance because they had not applied for it or because they were residents
				in medical or intermediate care facilities); and
(2) Entitled to a monthly insurance benefit
				under Title II of the Social Security Act (RSDI).
8. That part of the proceeds of a
				life insurance policy which is used to pay the last illness and burial expenses
				of the insured shall be excluded.
i. Last
				illness and burial expenses shall include related hospital, medical, funeral,
				burial plot, interment expenses, and related costs.
9. Refunds on taxes for food, real property,
				or income shall be exempt.
10. That
				portion of a grant, scholarship, or fellowship which is to be used to pay
				tuition and mandatory fees (as defined by the educational institution) shall be
				excluded.
11. The value of
				agricultural produce, if raised for home consumption, shall be
				excluded.
12. Certain irregular
				and/or infrequently received income shall be excluded as follows:
i. Unearned income which totals $ 60.00 or
				less per quarter (any consecutive three-month period), and which is received
				less frequently than twice per quarter or cannot be reasonably anticipated
				shall be excluded.
ii. Earned
				income which totals $ 30.00 or less per quarter (any consecutive three-month
				period), and which is received less frequently than twice per quarter or cannot
				be reasonably anticipated shall be excluded.
13. Monies paid to an individual as
				compensation for the care of a legally assigned foster child shall be excluded.
				(This income is not excludable if the child is an eligible individual in his or
				her own right, or if he or she does not reside in the home of the eligible
				individual(s).)
14. One-third of
				the amount received as child support from an absent parent shall be
				excluded.
15. Income received as
				compensation for services performed as an employee, or from self-employment, by
				an unmarried student who is under 22 years of age, shall be excluded to the
				extent that such income does not exceed $ 1,200 in a calendar quarter and/or $
				1,620 per calendar year.
i. A person shall be
				considered a student if he or she meets the following criteria:
(1) He or she is enrolled in a course or
				courses of study and attends to the extent required for continued enrollment.
				Specifically, a person must attend:
(A) A
				college or university at least eight semester or quarter hours weekly;
				or
(B) A secondary school at least
				12 clock hours weekly; or
(C) A
				course of vocational or technical training (other than at a secondary school,
				college, or university) designed to prepare the student for gainful employment
				involving shop practice, at least 15 clock hours a week; or without shop
				practice, at least 12 clock hours per week; or
(D) Less than the appropriate requirements in
				(a)15i(1)(A), (B), and (C) above, if it is determined that there are
				extenuating circumstances beyond the control of the student and he/she is
				pursuing a course of study comparable to the requirements of (a)15i(1)(A), (B),
				and (C) above.
(2) A
				student shall be considered in regular attendance if he or she is engaged in
				home study provided by a secondary school, college, university, or governmental
				agency, and a home visitor or tutor supervises the study or training. For
				purposes of this section, government-sponsored courses in the various
				self-improvement and anti-poverty programs are considered to be for the
				purposes of preparing the student for gainful employment.
(3) A student shall be considered in regular
				attendance during normal vacation periods if he or she is in regular attendance
				in the month immediately preceding and immediately following the vacation
				period.
(4) A student shall be
				considered to be in regular attendance for the month in which he or she
				completes or discontinues his or her school or training program.
16. Benefits provided
				under the State's Lifeline Utility Credit Program shall be excluded.
17. Interest on or appreciation in value of
				burial funds excluded from consideration as resources at
				10:71-4.4(b)9 
				shall be excluded from income.
18.
				The first $ 20.00 per month of income, other than income received as a VA
				pension based upon need, shall be excluded. This exclusion shall be applied
				first to unearned income, and any remaining amount of exclusion then applied to
				earned income. In the determination of countable income of a couple, this $
				20.00 exclusion is applied to the combined income of both.
19. Earned income, in the amount of $ 65.00
				per month plus one-half of the remaining sum, shall be excluded. In the
				determination of countable income of a couple, this exclusion applies to the
				combined earned income of both.
20.
				In the case of blind persons only, all expenses reasonably attributable to the
				earning of income shall be excluded.
21. In the case of blind or otherwise
				disabled persons, the amount of money which is needed to achieve an approved
				plan of self-support shall be excluded.
i. In
				order for this exclusion to apply, the plan of support must have been approved,
				in writing, by the Division of Vocational and Rehabilitation Services or the
				Commission for the Blind and Visually Impaired. The plan must also be
				current.