Net Income Test

Institutionalized Blind or Disabled Child

• If an un emancipated blind or disabled individual under 18 years of age, lives with at least one parent and then enters an institution, the resources of the parent(s) are deemed to the child for the month of eligibility.
• If an un emancipated blind or disabled individual under 21 years of age and in school lives with at least one parent and then enters an institution, the income of the parent(s) are deemed to the child for the month of eligibility.
• Calculate the child's countable gross unearned income
• Calculate the parent(s) countable gross unearned income
• Calculate the parent(s) countable gross earned income from all sources (including self employment income)
• Carry out the parent to child deeming process
• Add the total deemable income, if any, of the parent(s) to the eligible child's countable gross unearned income
• Apply unearned income deductions to the child's countable gross unearned income to determine the countable net unearned income
• Calculate the child's countable gross earned income from all sources (including self employment income)
• Apply earned income deductions to the child's countable gross earned income to determine the net earned income:
• Add the countable net unearned income and the countable net earned income to determine the total net countable income for the eligible child
• Compare net countable income to the state defined Long Term Care Income Eligibility Standard.

Disabled Child Exception

In the following cases, the child should be treated as a single institutionalized individual:

• If a baby, meeting disability criteria, is born in a hospital and is subsequently a resident of that hospital throughout the remainder of that month, the baby is considered to be a resident of the hospital throughout the month of his/her birth and no parental resources are deemed OR
• An infant who is born disabled, and who remains in the hospital for an extended time after birth is a resident of the medical institution from the date of birth and no parental resource are deemed.
• An emancipated child

Married Couple where Both Individuals Institutionalized

If both spouses are institutionalized, apply the following rules:

• Calculate the individual's countable gross unearned income
• Calculate the spouse's countable gross unearned income
• Combine the countable gross unearned income of the couple
• Apply unearned income deductions to the couple's income to determine the countable net unearned income
• Calculate the individual's countable gross earned income from all sources (including self employment income)
• Calculate the spouse's countable gross earned income from all sources (including self employment income)
• Combine the countable gross earned income of the couple
• Apply earned income deductions to the couple's income to determine the countable net earned income
• Add the countable gross unearned income and the countable gross earned income to determine the total gross countable income for the eligible couple
• Compare net countable income to the state defined Medically Needy Income Eligibility Standard.

  Exception: If spouses are both institutionalized but ineligible when treated as a couple, treat each spouse as an single institutionalized individual

Single Institutionalized Individual

• Total the individual's countable gross unearned income
• Apply unearned income deductions to determine the net unearned income
• Total the individual's countable gross earned income from all sources (including self employment income)
• Apply earned income deductions to determine the net earned income
• Total the individual's countable net earned and unearned income to give total net income.
• Compare net countable income to the state defined LTC Income Eligibility Standard.

Married Couple where One is Institutionalized and Other is Community Spouse

• Calculate the individual's countable gross unearned income
• Apply unearned income deductions to determine the net unearned income
• Calculate the individual's countable gross earned income from all sources (including self employment income)
• Apply earned income deductions to determine the net earned income
• Add the countable net unearned income and the countable net earned income to determine the total net countable income
• Compare net countable income to the state defined LTC Income Eligibility Standard.

Final Steps

1. Apply earned income deductions to determine the net earned income
2. Add the countable net unearned income and the countable net earned income to determine the total net countable income
3. Compare net countable income to the state defined state defined LTC Income Eligibility Standard.
4. Subtract the monthly LTC IES income limit for 1 person from the net countable income. This is the LTC Spend Down Liability. For more information on Spend Down, see the Cúram Medical Assistance with Spend Down Guide.