MR #19.04: 2019 Revised Medical Program Standards

03/29/19

Summary

Effective 01/01/19, updates the various medical program income standards which are based on the Federal Poverty Level Income Guidelines.
Provides information on the mass change update of medical cases effective April 2019 based on the revised income standards.
Updates the Program Standards Desk Aid.
Updates the Spousal Home Equity Limits.
Updates the current income thresholds for when a tax dependent, or child of another person in their eligibility determination group (EDG), is expected to be required to file a tax return.
Updates the maximum monthly Health Savings Account (HSA) MAGI deduction.
Updates the resource standard for Medicare Savings Program (QMB, SLIB, QI-1).

Increase in the Monthly Medical Income Standards

This release places in the manual the revised income standard for the programs listed below based on the 2019 Federal Poverty Level (FPL). The revised standards are effective 01/01/19 for all programs except MPE. The revised MPE standards are effective 2/17/2019.

The revised standards will be updated in IES on March 1, 2019 effective for April 2019. For pending applications and active cases, the new standards will be applied for any budget month beginning with January 2019.

Family Health Plans & ACA Adult Income Standards

Program	Link to WAG for Amounts
All Kids Assist All Kids Share All Kids Premium Level 1 FamilyCare Assist Moms & Babies ACA Adult MPE	WAG 25-03-02 (2)
All Kids Premium Level 2	WAG 25-02-02 (4)

Program

Link to WAG for Amounts

All Kids Assist

All Kids Share

All Kids Premium Level 1

FamilyCare Assist

Moms & Babies

ACA Adult

MPE

WAG 25-03-02 (2)

All Kids Premium Level 2

WAG 25-02-02 (4)

Monthly Income Standards for AABD, Medicare Cost Sharing

Program	Link to WAG for Amounts
AABD (community) Medicare Savings Programs (QMB, SLIB, QI-1) HBWD	WAG 25-03-02 (2)

Program

Link to WAG for Amounts

AABD (community)

Medicare Savings Programs (QMB, SLIB, QI-1)

HBWD

WAG 25-03-02 (2)

Family Assist and Family Health Spenddown Standards

There is no change in the Family Assist and Family Health Spenddown standards. Children and pregnant women who qualify for spenddown must spend down to the Family Health Spenddown standard.

Mass Change Action in IES

IES will process a mass change action as a result of the 2019 income standards update. The mass change will occur in March, effective April 2019. The following changes will be certified for individuals whose countable income is below the income limit for 2019:

All Kids Premium Level 2 to All Kids Premium Level 1;
All Kids Premium Level 1 to All Kids Share;
All Kids Share to All Kids Assist;
Family Health Spenddown to full coverage for certain children and pregnant women;
AABD spenddown to full coverage for certain AABD individuals;
QI-1 to SLIB; and
SLIB to QMB.

A form 360C Notice of Decision will be generated in IES.

Note: if the case is in benefit mismatch, Case Change or Redetermination Mode at the time of the mass change, IES will not update the case.

WAG 25 and the Program Standards Desk Aid

The Program Standards Desk Aid in WAG 25-03-02 has been updated with the revised income standards. The legacy coding charts in the Program Standards Desk Aid and WAG 25-03-02 (4) are replaced with the 185% income standard for Medical Extension cases and the income thresholds for a tax dependent who may be expected to be required to file a tax return.

Home Equity Limits

Home Equity Limits have been updated in WAG 25-03-02 (2).

Income Thresholds for a Tax Dependent Who May be Expected to be Required to File a Tax Return

The income amounts used to determine whether a tax dependent may be required to file a tax return using modified adjusted gross income (MAGI) budgeting in the 2019 calendar year are based on IRS rules for the 2018 tax year. The income threshold for earned income has increased from $529 to $1,000 per month while the income threshold for unearned income remains unchanged at $88 per month for the 2018 tax year: