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March 1 Federal Poverty Levels & MMPI budget brief

2012 Federal Poverty Level

On March 1 the Office of Medicaid will start using the new 2012 federal poverty levels.  MLRI's 2012 income standards table is posted here

Unfortunately, this year again the cost of living adjustment (COLA) in social security & the poverty levels are not in sync. Social Security benefits went up by 3.6% on Jan 1 compared to poverty level increase of 2.5% for a household of one & 2.85% for a household of 2.  The Office of Medicaid waits until after the March 1 poverty level adjustment to count the social security cost of living increase. Be on the look out for some currently eligible MassHealth recipients who may soon be getting notice that they are now over-income.

See if any of the following ideas may help clients/patients losing MassHealth based on this COLA bump (references are to the 2009 edition of the MLRI MassHealth Advocacy Guide), available at: /MassHealthAdvocacyGuide

1. Elderly individuals who need a Personal Care Attendant are eligible for an added income deduction to effectively raise their income standard from 100% to 133% of the poverty level.(Part 12, pp. 132-133)

2. Disabled individuals of any age including those age 65 or older may qualify for CommonHealth without a spenddown if they are working at least 40 hours per month. (Part 8 p. 81)

3. Disabled adults who are not working and the elderly may qualify for benefits after meeting a one-time or 6-month spenddown. (Part 12 pp. 128-131 and pp. 136-137)

4. Some former SSI recipients who would still qualify for SSI if certain social security benefits are not counted are eligible for Medicaid as "deemed" SSI recipients.  The three rules that provide this kind of protection apply to certain Disabled Adult Children (DAC), certain disabled widows (DAWs) and to any social security recipient who has received cost of living increases since last getting SSI (Pickle cases). (Part 3, pp. 28-30)

5. For individuals living in the community who meet a nursing home level of care, a higher income limit of $2094 per month applies for those eligible for HCBS waiver programs or PACE programs, but spaces in these programs are limited. (Part 11, pp. 117-118)

Budget Series

MMPI, Mass Budget & MLRI are once again putting out a series analyzing MassHealth and related health items in the development of the FY 2013 budget.