Income 510-05-85

 

Income Considerations 510-05-85-05

(Revised 4/1/11 ML #3263)

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(N.D.A.C. Section 75-02-02.1-34)

 

 

Income is defined as any cash payment, which is considered available to a Medicaid unit for current use. Income must be reasonably evaluated.

  1. All income which is actually available must be considered. Income is actually available when it is at the disposal of an applicant, recipient, or responsible relative; when the applicant, recipient, or responsible relative has a legal interest in a liquidated sum and has the legal ability to make the sum available for support, maintenance, or medical care; or when the applicant, recipient, or responsible relative has the lawful power to make the income available or to cause the income to be made available.

 

An individual may have rights, authority, or powers that he or she does not wish to exercise. An example includes an individual who allows a relative to use excluded or exempted assets free or at a reduced rental. In such cases, a fair rental amount will be counted as available income whether the applicant or recipient actually receives the income.

 

Income that is withheld because of garnishment or to pay a debt or other legal obligation is still considered available.

 

Title II and SSI overpayments being deducted from Title II benefits are normally considered to be available because the applicant or recipient can pursue a waiver of the overpayment. Only if the waiver has been denied after a good faith effort, can the Title II or SSI overpayment deductions be considered unavailable. Occasionally other delinquent debts owed to the federal government may be collected from an individual’s Title II benefit. These other reductions of Title II benefits are generally not allowed to reduce the countable benefit amount. The award amount of the Title II benefit is counted as available except to the extent an undue hardship is approved for the individual.

 

Requests for undue hardship exceptions must be submitted to the Medicaid Eligibility Unit where a determination will be made whether an undue hardship exists.  An undue hardship may be determined to exist for all or a portion of the debt owed, or all or a portion of the reduction from the monthly income.

 

An undue hardship will be determined to exist only if the individual shows all of the following conditions are met:

  1. The debt is a debt owed to the Federal government;
  2. The deduction from the individual’s Title II benefit was non-voluntary;
  3. The amount of the deduction exceeds the Medicaid income level(s) to which the individual and the individual’s spouse is subject;
  4. The individual has exhausted all lawful avenues to get the reduction waived, forgiven, or deferred; and
  5. The individual or their spouse do not own assets that can be used to pay for the debt.
  1. The financial responsibility of any individual for any applicant or recipient of Medicaid will be limited to the responsibility of spouse for spouse and parents for children under age twenty-one. Such responsibility is imposed as a condition of eligibility for Medicaid. Except as otherwise provided in this section, the income of the spouse and parents is considered available even if that income is not actually contributed. Natural and adoptive parents, but not stepparents, are treated as parents (exceptions to counting a stepparent’s income applies when the stepparent is the only eligible caretaker and is eligible for Medicaid because of the child, as described in 05-35-20(2) or when budgeting for Transitional Medicaid Benefits as described in 05-50-05(7)).
  2. All spousal income is considered actually available unless:
  1. A court order, entered following a contested case, determines the amounts of support that a spouse must pay to the applicant or recipient;
  2. The spouse from whom support could ordinarily be sought, and the property of such spouse, is outside the jurisdiction of the courts of the United States; or
  3. The applicant or recipient is subject to marital separation, with or without court order, and there has been no collusion between the applicant or recipient and his or her spouse, to render the applicant or family member eligible for Medicaid.
  1. All parental income is considered actually available to a child unless:
  1. The child is disabled and at least age eighteen;
  2. The child is living independently; or
  3. The child is living with a parent who is separated from the child’s other parent, with or without court order, if the parents did not separate for the purpose of securing Medicaid benefits.
  1. Income may be received weekly, biweekly, monthly, intermittently, or annually. However income is received, a monthly income amount must be computed.