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Virginia Administrative Code
Title 12. Health
Agency 30. Department of Medical Assistance Services
Chapter 40. Eligibility Conditions and Requirements
7/9/2020

12VAC30-40-90. Income and Resource Levels and Methods.

Part III
Financial Eligibility

Article 1
General

A. For individuals who are AFDC-related medically needy or SSI recipients, the income and resource levels and methods for determining countable income and resources of the AFDC and SSI program apply, unless the plan provides for more restrictive levels and methods than SSI for SSI recipients under § 1902(f) of the Act, or more liberal methods under § 1902(r)(2) of the Act, as specified in this section.

B. For individuals who are not AFDC-related medically needy or SSI recipients in a non-section 1902(f) state and those who are deemed to be cash assistance recipients, the financial eligibility requirements specified in this article apply.

C. 12VAC30-40-100 specifies the methods for determining income for individuals evaluated using modified adjusted gross income (MAGI) methodology.

D. 12VAC30-40-220 specifies the income levels for mandatory and optional categorically needy groups of individuals, including individuals with incomes related to the federal income poverty level, that is pregnant women and infants or children covered under §§ 1902(a)(10)(A)(i)(IV), 1902(a)(10)(A)(i)(VI), 1902(a)(10)(A)(i)(VII), and 1902(a)(10)(A)(ii)(IX) of the Act and aged and disabled individuals covered under § 1902(a)(10)(A)(ii)(X) of the Act, and for mandatory groups of qualified Medicare beneficiaries covered under § 1902(a)(10)(E)(i) of the Act.

E. 12VAC30-40-230 specifies the resource levels for mandatory and optional categorically needy poverty level related groups and for medically needy groups.

F. 12VAC30-40-260 specifies the income levels for categorically needy aged, blind, and disabled persons who are covered under requirements more restrictive than SSI.

G. 12VAC30-40-240 specifies the methods for determining resource eligibility used by states that have more restrictive methods than SSI, permitted under § 1902(f) of the Act.

H. 12VAC30-40-270 specifies the resource standards to be applied for categorically needy individuals in states that have elected to impose more restrictive eligibility requirements than SSI, permitted under § 1902(f) of the Act.

I. 12VAC30-40-280 specifies the methods for determining income eligibility used by states that are more liberal than the methods of the cash assistance programs, permitted under § 1902(r)(2) of the Act.

J. 12VAC30-40-290 specifies the methods for determining resource eligibility used by states that are more liberal than the methods of the cash assistance programs, permitted under § 1902(r)(2) of the Act.

Statutory Authority

§ 32.1-325 of the Code of Virginia; 42 USC § 1396 et seq.

Historical Notes

Derived from VR460-02-2.6100 C, eff. July 1, 1993; amended, VR460-02-2.6100:1, eff. November 15, 1995; Volume 33, Issue 21, eff. July 27, 2017.

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