Income limits for LTC programs vary depending on the services needed, living situation, and marital status. Some income may be allocated to a spouse and any dependents in the home. The client living at home keeps some income for home maintenance and personal needs. If the client is living in a residential setting, or alternate living facility (ALF), such as an adult family home or adult residential care facility, the amount of income kept depends upon the particular services received. The client who is living in a nursing facility (NF) may keep a small personal needs allowance (PNA) for clothing and incidental expenses. All remaining income is paid toward the cost of care; this is called "participation".

Resource limits also vary depending on marital status and other factors. All resources of both spouses are considered together. Certain resources are "exempt," such as the home, household goods and personal effects, a car, life insurance with a face value not more than $1,500.  Most burial plots and prepaid revocable burial plans not exceeding $1,500, or irrevocable burial plans are also exempt and not counted toward the resource limits.

A Community Spouse (CS) is allowed to keep resources according to spousal impoverishment legislation. The Institutionalized Spouse (IS) is allowed to keep the same resources indicated in the table above for ABD clients.

A different income standard is used to determine eligibility for categorically needy (CN) or medically needy (MN) coverage for LTC services.  The standard is 300% of the FBR and is called the Special Income Level (SIL). If income is at or below the SIL and countable resources are below the maximum, CN eligibility for either NF or HCBS, such as Community Options Program Entry System (COPES), may be approved. If countable income or resources are above the SIL, MN eligibility may be approved with a spenddown. Different rules are used when determining eligibility and participation when both spouses receive LTC services. The local Home and Community Services worker can provide this information as needed.

1* - January, 2009 Changes
2* - April, 2009 Changes
3* - July, 2008 Changes
4* - October, 2008 Changes

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