Income Levels 510-05-85-40
(Revised 1/11/2023 ML #3695)
(N.D.A.C. Sections 75-02-02.1-40, 75-02-02.1-22(7), 75-02-02.1-24.2(8), and 75-02-02.1-24(5))
Levels of income for maintenance must be used as a basis for establishing financial eligibility for Medicaid. The Medicaid income levels represent the amount of income reserved to meet the maintenance needs of an individual or family. The income levels applicable to individuals and units are:
- Categorically needy income levels.
- Categorically needy aged, blind, and disabled recipients. Except for individuals subject to the nursing care income level, the income level which establishes SSI eligibility.
- Medically needy income levels.
- Medically needy income levels are applied when a Medicaid individual or unit resides in their own home or in a specialized facility, and when a Medicaid individual has been screened as requiring nursing care, but elects to receive HCBS. The income level is equal to 83% of the poverty level applicable to a Medicaid Unit of the size involved. The Medicaid Unit size is increased for each unborn when determining the appropriate Medicaid Unit size.
|
Number of Persons |
Monthly Income Level |
|
1 |
$940 |
|
2 |
1,267 |
|
3 |
1,593 |
|
4 |
1,920 |
|
5 |
2,246 |
|
6 |
2,573 |
|
7 |
2,899 |
|
8 |
3,226 |
|
9 |
3,552 |
|
10 |
3,879 |
| (+1) | $327 |
| Effective April 1, 2022 | |
- Nursing care income level. The nursing care income level is sixty-five dollars per month and must be applied to residents receiving psychiatric or nursing care services in nursing facilities, the state hospital, the Prairie at Saint John's, Red River Behavioral Health System, a Psychiatric Residential Treatment Facility (PRTF), or receiving swing bed care in a hospital.
- ICF-ID income level. The income level for a resident of an Intermediate Care Facility for the intellectually disabled (ICF-ID), is $100 effective October 1, 2010.
- Community spouse income level. The income level for a community spouse who is eligible for Medicaid is subject to the categorically needy, medically needy, or poverty level income levels. The level for an ineligible community spouse is $2550, or a higher amount if ordered by a court or hearing officer.
- Family member income level. The income level for each ineligible family member in a spousal impoverishment case is $763 effective July 2022 ($726 effective July 2021).
- Poverty income levels.
- Qualified
Medicare Beneficiaries and Children age six to nineteen. Effective with new applicants and reviews for benefits starting January 1, 2014, children will not be covered under this income level. Those approved whose benefits started prior to January 2014 are subject to this income level until their next review. The income
level is equal to 100% of the poverty level applicable
to a Medicaid Unit of the size involved.
For Qualified Medicare Beneficiaries these levels
apply regardless of living arrangements (i.e., in home or in a nursing
facility...).
Annual Title
II cost of living allowances effective in January shall be disregarded
when determining eligibility for QMBs for January, February, and March.
This disregard prevents QMBs from becoming ineligible pending issuance
of the new poverty levels which are effective April 1 of each year.
The Medicaid Unit size is increased for each unborn when determining the appropriate Medicaid Unit size.
| Number of Persons |
Monthly Income Level |
|
1 |
$ 1,133 |
|
2 |
1,526 |
|
3 |
1,920 |
|
4 |
2,313 |
|
5 |
2,706 |
|
6 |
3,100 |
|
7 |
3,493 |
|
8 |
3,886 |
|
9 |
4,280 |
|
10 |
4,673 |
| (+1) | $379 |
| Effective April 1, 2022 | |
- Specified Low-Income Medicare Beneficiaries. The income level is equal to 120% of the poverty level applicable to a Medicaid Unit of the size involved. This is the maximum income level for SLMBs. Applicants or recipients who have income at or below one hundred percent of the poverty level are not eligible as a SLMB, but must be a QMB. These income levels apply regardless of living arrangements (i.e., in home or in a nursing facility. . .).
Annual Title II cost of living allowances effective in January shall be disregarded when determining eligibility for SLMBs for January, February, and March. This disregard prevents SLMBs from becoming ineligible pending issuance of the new poverty levels which are effective April 1 of each year.
The Medicaid Unit size is increased for each unborn when determining the appropriate Medicaid Unit size.
|
Number of Persons |
Monthly Income Level |
|
1 |
$1,359 |
|
2 |
1,831 |
|
3 |
2,303 |
|
4 |
2,775 |
|
5 |
3,247 |
|
6 |
3,719 |
|
7 |
4,191 |
|
8 |
4,663 |
|
9 |
5,135 |
|
10 |
5,607 |
| (+1) | $472 |
| Effective April 1, 2022 | |
- Qualifying Individuals. The income level is equal to 135% of the poverty level applicable to a Medicaid Unit of the size involved. This is the maximum income level for QIs. Applicants or recipients who have income at or below 120% of the poverty level are not eligible as a QI, but may be eligible as a SLMB or QMB. These income levels apply regardless of living arrangements (i.e., in home or in a nursing facility...).
Annual Title II cost of living allowances effective
in January shall be disregarded when determining eligibility for QIs for
January, February, and March. This disregard prevents QIs from becoming
ineligible pending issuance of the new poverty levels, which are effective
April 1 of each year.
The Medicaid Unit size is increased for each unborn when determining the appropriate Medicaid Unit size.
|
Number of Persons |
Monthly Income Level |
|
|
1 |
$1,529 |
|
|
2 |
2,060 |
|
|
3 |
2,591 |
|
|
4 |
3,122 |
|
|
5 |
3,653 |
|
|
6 |
4,184 |
|
|
7 |
4,715 |
|
|
8 |
5,246 |
|
|
9 |
5,777 |
|
|
10 |
6,308 |
|
| (+1) | $531 | |
|
Effective April 1, 2022 |
||
- Workers
with Disabilities. The
income level is equal to 225% of the poverty
level applicable to a Medicaid Unit of the size involved.
The Medicaid Unit size is increased for each unborn when determining the appropriate Medicaid Unit size.
|
Number of Persons |
Monthly Income Level |
|
1 |
$2,549 |
|
2 |
3,434 |
|
3 |
4,319 |
|
4 |
5,204 |
|
5 |
6,089 |
|
6 |
6,974 |
|
7 |
7,859 |
|
8 |
8,744 |
|
9 |
9,629 |
|
10 |
10,514 |
| (+1) | $885 |
| Effective April 1, 2022 | |
- Children with
Disabilities. The income level is equal to 250% of the
poverty level applicable to the Medicaid Unit size involved.
The Medicaid Unit size is increased for each unborn when determining the appropriate Medicaid Unit size.
|
Number of Persons |
Monthly Income Level |
|
1 |
$2,832 |
|
2 |
3,815 |
|
3 |
4,798 |
|
4 |
5,782 |
|
5 |
6,765 |
|
6 |
7,748 |
|
7 |
8,732 |
|
8 |
9,715 |
|
9 |
10,698 |
|
10 |
11,682 |
| (+1) | $984 |
| Effective April 1, 2022 | |
