GIS 10 MA/026: 2011 SSI, LIF/SCC Medicaid Standard and Medicaid Income and Resource Levels

The purpose of this General Information System (GIS) message is to advise local Department of Social Services (LDSS) of the income levels and figures used in determining Medicaid eligibility, effective January 1, 2011.

There will also be no increase in the spousal impoverishment standards for 2011.

The Medicaid Income Standard used for Singles/Childless Couples and Low Income Families will be minimally adjusted to reflect an increase in the September 2010 Consumer Price Index (CPI-U). The new Medicaid Income Standard levels will be available on January 3, 2011, for MBL budgets with a "From" date of January 1, 2011.

For 2011, Federal Poverty Levels will not be estimated and will be updated when the actual amounts are published in the Federal Register. At that time, a mass rebudgeting of affected cases may be performed. Further information will be forthcoming.

Effective January 1, 2011, Medicaid eligibility must be determined using the following figures:

• 1. Medicaid Income Standards and Medically Needy Income Levels.

Household Size	Medicaid Standard S/CC - LIF		Medically Needy Income Levels
	Annual	Monthly	Annual	Monthly	Resources
One	8,487	708	9,200	767	13,800
Two	10,595	883	13,400	1,117	201,00
Three	12,606	1,051	15,410	1,285	23,115
Four	14,637	1,220	17,420	1,452	26,130

• 2. The Supplemental Security Income federal benefit rate (FBR) for an individual living alone remains $674/single and $1,011/couple.
• 3. The allocation amount remains $350, the difference between the Medicaid level for a household of two and one.
• 4. The 249e factors remain .965 and .174.
• 5. The SSI resource levels remain $2,000 for individuals and $3,000 for couples.
• 6. The state supplement remains $87 for an individual and $104 for a couple living alone.
• 7. The Medicare Part A Hospital Insurance Base Premium is $248/month for people having 30-39 work quarters and $450/month for people who are not otherwise eligible for premium-free hospital insurance and have less than 30 quarters.
• 8. The Medicare Part B Supplemental Medical Insurance Base Premium is $115.40/month. Individuals who are subject to the "hold harmless" provision will not see an increase in their Medicare Part B premium for 2011. Premiums will remain at the 2010 rate of $110.50 for 2011, if the individual began paying Part B premiums in 2010. Premiums will remain at the 2009 rate of $96.50 for 2011, if the individual began paying Part B premiums in 2009. However, if NYS Medicaid is paying the Part B premiums under the Medicare Savings Plan (MSP), Medicaid will pay the full cost of the premium, $115.40, for 2011.
• 9. The Maximum federal Community Spouse Resource Allowance remains $109,560.
• 10. The Minimum State Community Spouse Resource Allowance remains $74,820.
• 11. The community spouse Minimum Monthly Maintenance Needs Allowance (MMMNA) remains $2,739.
• 12. Personal Needs Allowance for certain waiver participants subject to spousal impoverishment budgeting remains $350.
• 13. Family Member Allowance formula number remains $1,822 until the FPLs for 2011 are published in the Federal Register.
• 14. Maximum Family Member Allowance remains $608 until the FPLs for 2011 are published in the Federal Register.
• 15. Substantial Gainful Activity (SGA): Non-Blind $1,000/month, Blind $1,640/month, Trial Work Period (TWP) $720/month.
• 16. SSI-related student earned income disregard limit of $1,640/monthly up to a maximum of $6,600/annually.

Please direct any questions to the Local District Support Unit at 518-474-8887 Upstate and 212-417-4500 for NYC.