Income Levels 510-05-85-40

(Revised 7/1/2024 ML #3833)

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(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:

 

  1. Categorically needy income levels.
  1. Categorically needy aged, blind, and disabled recipients. Except for individuals subject to the nursing care income level, the income level which establishes SSI eligibility.

 

  1. Medically needy income levels.
  1. 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 90% 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

1,130

2

1,533

3

1,937

4

2,340

5

2,744

6

3,147

7

3,551

8

 3,954

9

4,358

10

4,761
(+1) $404
Effective April 1, 2024
  1. Nursing care income level. The nursing care income level is $100 per month and must be applied to residents receiving psychiatric or nursing care services in nursing facilities, the state hospital,Prairie Saint John's, a Psychiatric Residential Treatment Facility (PRTF), or receiving swing bed care in a hospital.
  2. ICF-ID income level. The income level for a resident of an Intermediate Care Facility for the intellectually disabled (ICF-ID), is $135 effective July 1,2023.
  3. 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 $2555, or a higher amount if ordered by a court or hearing officer.
  4.  Family member income level. The income level for each ineligible family member in a spousal impoverishment case is $852 effective July 2024 ($822 effective July 2023).
  1. Poverty income levels.
  1. Qualified Medicare Beneficiaries 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

 1,255

2

1,704

3

2,152

4

2,600

5

3,049

6

3,497

7

3,945

8

4,394

9

4,842

10

5,290
(+1) $449
Effective April 1, 2024

 

  1. 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

1,506

2

2,044

3

2,582

4

3,120

5

3,658

6

4,196

7

4,734

8

5,272

9

5,810

10

6,348
(+1) $538
Effective April 1, 2024

 

  1. 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

 $1,695

2

2,300

3

2,905

4

3,510

5

4,116

6

4,721

7

5,326

8

5,931

9

6,537

10

  7,142
(+1) $606

Effective April 1, 2024

  

 

  1. 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

 $2,824

2

3,833

3

4,842

4

5,850

5

6,859

6

7,868

7

8,877

8

9,885

9

10,894

10

11,903
(+1) $1,009
Effective April 1, 2024

 

  1. 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

 $3,148

2

4,259

3

5,380

4

6,500

5

7,621

6

8,742

7

9,863

8

10,984

9

12,105

10

13,225
(+1) $1,121
Effective April 1, 2024

 

  1. Breast and Cervical Cancer Early Detection Program and Refugee Medical Assistance income levels.

    1. The income level is equal to 200% of the poverty level applicable to a Medicaid Unit of the size involved.

       

      Number of Persons

      Monthly Income Level

      1

       $2,510

      2

      3,407

      3

      4,304

      4

      5,200

      5

      6,097

      6

      6,994

      7

      7,890

      8

      8,787

      9

      9,684

      10

      10,580
      (+1) $897
      Effective April 1, 2024