5172            INCOME ELIGIBILITY

To determine income eligibility for Family Medicaid, the household must pass both income tests identified below:

1.  Gross Income Test (185%)

The household must pass the gross income test first.  The household's gross countable income is totaled and compared to the applicable 185% Standard for their household size and type.  See Addendum - 2.

If the household has countable gross income of $0.01 or more above the applicable 185% Standard, they “fail” and are not eligible for Family Medicaid.

If the household has countable gross income equal to or less than the applicable 185% Standard, they “pass” the Gross Income Test and the caseworker must then evaluate eligibility using the Net Income Test.

Note:  

The income disregards identified in manual section 5165 are not included in calculating the amount of income used in the Gross Income Test.

2.  Net Income Test

If the household passes the Gross Income Test, their income eligibility must be evaluated using the Net Income Test.  The household’s countable gross income is reduced by the income disregards identified in manual section 5165.  The resulting net income is compared to the appropriate Net Income Standard for the household size and type.  See Addendum - 2.

If the household has countable net income of $0.01 or more above the Net Income Standard for the household, they "fail" and are not eligible for Family Medicaid.

If the household has countable net income equal to or less than the Net Income Standard for the household, they "pass" the Net Income Test. Family Medicaid eligibility exists if all the other eligibility factors have been met.