Virginia Administrative Code › Title 12 - HEALTH › Agency 30 - DEPARTMENT OF MEDICAL ASSISTANCE SERVICES › Chapter 40 - ELIGIBILITY CONDITIONS AND REQUIREMENTS › Part IV - Eligibility Requirements › Section 12VAC30-40-280 - More liberal income disregards

Current through Register Vol. 40, No. 24, July 15, 2024
A. For ADC-related medically needy cases, any
				  individual or family applying for or receiving assistance shall be granted an
				  income exemption consistent with the Social Security Act (Act) (§§
				  1902(a)(10)(A)(ii)(VIII), (IX) and 1902(a)(10)(C)(ii)(I)). Any interest earned
				  on one interest-bearing savings or investment account per assistance unit not
				  to exceed $5,000, if the applicant, applicants, recipient or recipients
				  designate that the account is reserved for purposes related to
				  self-sufficiency, shall be exempt when determining eligibility for medical
				  assistance for so long as the funds and interest remain on deposit in the
				  account. For purposes of this section, "purposes related to self-sufficiency"
				  shall include (i) paying for tuition, books, and incidental expenses at any
				  elementary, secondary, or vocational school, or any college or university; (ii)
				  for making down payment on a primary residence; or (iii) for establishment of a
				  commercial operation that is owned by a member of the Medicaid assistance
				  unit.
B. For aged, blind, and
				  disabled individuals, both categorically and medically needy, with the
				  exception of the special income level group of institutionalized individuals,
				  the Commonwealth of Virginia shall disregard the value of in-kind support and
				  maintenance when determining eligibility. In-kind support and maintenance means
				  food, clothing, or shelter or any combination of these provided to an
				  individual.
C. For all medically
				  needy children covered under the family and children covered groups,
				  (§§ 1902(a)(10)(A)(ii)(VIII), 1902(a)(10)(C)(ii)(I), and 1905(n) of
				  the Act), the Commonwealth will disregard all earned income of a child under
				  the age of 19 years who is a student.
D. For all medically needy individuals
				  covered under the family and children covered groups (§§
				  1902(a)(10)(A)(ii)(VIII), 1902(a)(10)(C)(ii)(I), and 1905(n) of the Act), the
				  Commonwealth will disregard the fair market value of all in-kind support and
				  maintenance as income in determining financial eligibility. In-kind support and
				  maintenance means food, clothing or shelter or any combination of these
				  provided to an individual.
E.
				  Working individuals with disabilities eligible for assistance under §
				  1902(a)(10)(A)(ii)(XV) of the Act who wish to increase their earnings while
				  maintaining eligibility for Medicaid must establish Work Incentive (WIN)
				  accounts (see
				  12VAC30-40-290
				  ).
1. The Commonwealth shall disregard any
				  increase in the amount of unearned income in Social Security Disability
				  Insurance (SSDI) payment resulting from employment as a worker with
				  disabilities eligible for assistance under § 1902(a)(10)(A)(ii)(XVI) of
				  the Act, or as a result of a cost of living adjustment (COLA) to the SSDI
				  payment if this additional amount of unearned income in SSDI payment from work
				  or COLA, or both, is deposited into the individual's designated WIN
				  account.
2. The Commonwealth shall
				  disregard any amount of unearned income of an enrollee as a result of the
				  receipt of unemployment insurance benefits due to loss of employment through no
				  fault of his own if this unearned income from unemployment insurance payments
				  is deposited into the individual's designated WIN account. This disregard shall
				  only apply while an enrollee is in the six-month safety net, or "grace"
				  period.
3. The Commonwealth shall
				  disregard earned income up to $75,000 for workers with disabilities eligible
				  for assistance under § 1902(a)(10)(A)(ii)(XV) of the Act. To be eligible
				  for this earned income disregard, the income is subject to the following
				  provisions:
a. Only earnings that are
				  deposited into a Work Incentive (WIN) account can be disregarded for
				  eligibility purposes.
b. All funds
				  deposited and their source will be identified and registered with the
				  department, for which prior approval has been obtained from the department, and
				  for which the owner authorizes regular monitoring and reporting of these
				  earnings and other information deemed necessary by the department for the
				  proper administration of this provision.
c. Income from the individual's spouse, or if
				  the individual is younger than 21 years of age, the individual's parents with
				  whom he lives, will not be deemed to an applicant for MEDICAID WORKS or to an
				  existing enrollee in MEDICAID WORKS when determining whether or not the
				  individual meets the financial eligibility requirements for eligibility under
				  this section.