Presumptive Eligibility Policies and Procedures Handbook

Income

To determine a household’s income, include any non-exempt income received by members of the household and deduct any acceptable expenses. See chart below for listing of the non-exempt types of income. Earned Income ‐ Income an individual receives for a certain degree of activity or work. Earned income entitles the individual to work-related deductions. Unearned Income ‐ Payments received without performing work-related activities, including benefits from other programs.
Income = earned income + unearned income + self-employment income ‐ expenses ‐ income disregard
Types of Income
Earned Income Wages and Tips
On-the-job training income
Welfare-to-work income
Unearned Income Military allotment
Vacation pay
Capital gains
Interest
Note Interest
Dividends
Royalties
Award prizes
Alimony received
RSDI
Unemployment compensation
Pension/retirement
Railroad retirement
Annuity
Canceled Debts
Court Awards
Jury duty pay
Life estate
Trust payments
Gifts or contributions
Self-employment Income Rental
Farming/fishing
Sales
Construction/repair work
Commission
Odd jobs
Contract/seasonal work
Other income

Income Conversions

All income must be converted to a monthly amount. Use the following conversion factors to convert incomes to a monthly amount.
if Paid Then Multiply
weekly gross pay x 4.33
every other week gross pay x 2.17
semi-monthly gross pay x 2
NOTE: Divide yearly income by 12 for monthly income. Clients may not have the weekly/biweekly gross pay. To calculate the gross pay, multiply the hourly amount by the number of hours worked per week.

Examples

Mrs. Callahan works 30 hours per week at $7.24 per hour; she is paid weekly.
30 x $7.24 = $217.20 weekly gross earnings
The converted monthly income is
$217.20 x 4.33 = $940.48
Mr. Burns works 40 hours per week at $7.15 per hour; he is paid biweekly.
40 x $7.15 x 2 = $572.00 biweekly gross earnings
The converted monthly income is
$572.00 x 2.17 = $1241.24

Expenses

Allowable expenses include:
  • Alimony paid
  • Educational expenses/student loan interest
  • Moving expenses
  • Tuition or GI Bill (military)
  • Educator expenses
  • Expenses of reservists, performing artists, or fee-basis government officials
  • Health savings account
  • Deductible part of self-employment tax
  • Self-employed IRA, simple IRA, and qualified plan deductions
  • Self-employed health insurance
  • Penalty on early withdrawal of savings deduction
  • IRA deduction
  • Domestic production activities deduction
  • Domestic production activities deduction
  • Costs related to self-employment income such as labor, sales tax, stock, raw materials, rent, insurance

Disregards

Once the income has been calculated, subtract the standard income disregard, which provides the total net income. The income disregard is equal to five percentage points of the Federal Poverty Level (FPL) for the applicable household size. The table below shows the disregard amounts by household size:

Standard MAGI Disregard
Five Percentage Points of FPIL (March 2021 - Ongoing)
Family Size
Standard Income Disregard
1
$53.70
2
$72.60
3
$91.50
4
$110.45
5
$129.35
6
$148.25
7
$167.20
8
$186.10
9
$205.00
10
$223.95
11
$242.85
12
$261.75
13
$280.70
14
$299.60
15
$318.50
Each Added person
$18.95

Once the income has been determined, identify the maximum household income for the relevant household size and applicable Medicaid program. If the income is equal to or less than the maximum household income, the individual is eligible for Short-term Medicaid, if all other eligibility criteria are met.

Income Limits

Use the charts found here to determine whether an applicant is at or below the relevant income limit.