THIS DOCUMENT IS FOR ARCHIVE PURPOSES ONLY AND MAY NOT REFLECT CURRENT POLICY. Medical Assistance Eligibility Policy Manual (Archive) - Part 3 of 3 Effective until 2021-08-06 THIS DOCUMENT IS FOR ARCHIVE PURPOSES ONLY AND MAY NOT REFLECT CURRENT POLICY. Table of Contents Introduction ................................................................................................................... 11 Getting Started .......................................................................................................... 12 Getting Started ....................................................................................................... 12 Cash Assistance and Nutrition Assistance Policy ...................................................... 18 Example ........................................................................................................................ 19 Examples ................................................................................................................... 19 Introduction ................................................................................................................ 20 E508 Community Spouse Example ........................................................................... 21 E602 Budget Group Examples .................................................................................. 22 E602 Budget Group Examples ............................................................................... 22 A MAGI Budget Group Examples ........................................................................... 23 B Conflicting Tax Information ................................................................................. 31 E603 Examples for What is not Income ..................................................................... 32 E603 Examples for What is not Income ................................................................. 32 A Return of an incorrect payment ........................................................................... 33 B Vendor Payment ................................................................................................. 34 E604 Receipt of Income Examples ............................................................................ 35 E604 Receipt of Income Examples ........................................................................ 35 A Example Revocably Assigned Income ................................................................ 36 B Example Irrevocably and Permanently Assigned Income ................................... 37 C Example Irrevocably and Periodically Assigned Income .................................... 38 D Example Income received on behalf of another person ...................................... 39 Effective until 2021-08-06 THIS DOCUMENT IS FOR ARCHIVE PURPOSES ONLY AND MAY NOT REFLECT CURRENT POLICY. E Example Five weekly payments received in a month ......................................... 40 F Example Three bi-weekly payments received in a month ................................... 41 G Example Contract periods that cover more than one calendar year ................... 42 H Example Contract anticipated to be renewed .................................................. 43 I Example Seasonal income ................................................................................... 44 J Example Changes in pay rate ............................................................................. 45 K Example Changes in work hours ........................................................................ 46 L Example Zero pay periods .................................................................................. 47 E605 Verifying Income Examples .............................................................................. 48 E605 Verifying Income Examples .......................................................................... 48 A Examples - Reasonable compatibility .............................................................. 49 E606 Types of Income ............................................................................................... 50 E606 Types of Income ........................................................................................... 50 A Allocated Income ................................................................................................ 51 B Disability Insurance Payments Examples ........................................................... 53 C Indian Gaming Profit Distribution ........................................................................ 54 D Indian Income from Protected Rights and Resources ........................................ 55 E Self-Employment Loss Example ......................................................................... 56 F Arizona State Retirement System with Health Insurance Supplement Examples 57 G Crowdfunding ..................................................................................................... 59 E608 Income Deeming Examples ............................................................................. 60 E608 Income Deeming Examples .......................................................................... 60 A Sponsor Deeming - Counting Only Current and Past Quarters .......................... 61 Effective until 2021-08-06 THIS DOCUMENT IS FOR ARCHIVE PURPOSES ONLY AND MAY NOT REFLECT CURRENT POLICY. E609 Modified Adjusted Gross Income (MAGI) Deductions - Examples ................... 62 E610 Examples for Calculating Income Eligibility for ALTCS .................................... 65 E610 Examples for Calculating Income Eligibility for ALTCS ................................. 65 A Gross Test Calculation - Non-Community Spouse ............................................. 66 B Gross Income Test Calculation - Community Spouse ........................................ 67 C Net Income Test Examples ................................................................................ 71 E611 Calculating Income Eligibility for SSI-MAO Examples ...................................... 78 E611 Calculating Income Eligibility for SSI-MAO Examples .................................. 78 A Calculation for the Customer Only Examples .................................................. 79 B Calculation for Customer and Spouse Examples ................................................ 82 C Calculation for Customer Child and Ineligible Parents Example ......................... 85 E612 MSP Income Eligibility Calculation Examples................................................... 89 E612 MSP Income Eligibility Calculation Examples ............................................... 89 A Customer Only Calculation ................................................................................. 90 B Customer and Spouse Calculation Example ................................................... 92 C Income calculation - Customer child w/ ineligible parents .................................. 94 E613 How to Calculate FTW Income Eligibility .......................................................... 99 E614 Income of Children and Tax Dependents for MAGI ........................................ 101 E703 Resource Treatment Examples ...................................................................... 103 E703 Resource Treatment Examples .................................................................. 103 A Commingled Funds Examples .......................................................................... 104 B Constructively Received Examples ................................................................... 105 C Long Term Care Partnership Program Exclusion Example .............................. 107 Effective until 2021-08-06 THIS DOCUMENT IS FOR ARCHIVE PURPOSES ONLY AND MAY NOT REFLECT CURRENT POLICY. E704 Ownership of Resources ................................................................................ 108 E704 Ownership of Resources............................................................................. 108 A Equitable Ownership Example .......................................................................... 109 E705 Resource Type Examples .............................................................................. 110 E705 Resource Type Examples ........................................................................... 110 A Burial Funds Examples ..................................................................................... 111 B Home Property ............................................................................................... 114 C Property Essential to Self-Support .................................................................... 116 D Promissory Notes, Loans and Property Agreement Examples ......................... 118 E707 Community Spouse Resource Budgeting Examples ...................................... 120 E707 Community Spouse Resource Budgeting Examples .................................. 120 A Ineligible Month in Initial Period Example ...................................................... 121 B Ending the Initial Period early - Resources increased ................................... 122 C Community Spouse Resource Deduction Examples ........................................ 123 D Establishing FCPI Example .............................................................................. 126 E Community Spouse Resource Calculation..................................................... 127 E802 Non-Special Treatment Trusts Examples ....................................................... 128 E802 Non-Special Treatment Trusts