New Jersey Administrative Code
Title 10 - HUMAN SERVICES
Chapter 71 - MEDICAID ONLY
Subchapter 5 - INCOME
Section 10:71-5.2 - Determination of countable income
Universal Citation: NJ Admin Code 10:71-5.2
Current through Register Vol. 56, No. 18, September 16, 2024
(a) Countable income shall be determined by adding the applicant's nonexempt unearned income (less appropriate exclusions) to his/her earned income (less appropriate exclusions).
(b) Procedures regarding the determination of income eligibility shall be as follows:
1. Determination of initial income
eligibility shall be based on all earned and unearned income which has or will
be received during the month for which application is made, beginning with the
first day of such month, except that quarterly, semiannual, or annual payments
shall be prorated in accordance with (b)2 below. (See
10:71-5.3(a)15
regarding exclusion of student earnings.)
2. The following shall apply to income
received other than monthly:
i. Income
received weekly shall be multiplied by 4.333 to determine the monthly amount;
biweekly income shall be multiplied by 2.167. (If earned income is irregular,
the initial determination shall be based on the average of the amounts received
for any four weeks within the 10 week period which includes the five weeks
immediately before and after the date of application.)
ii. When income received on a quarterly,
semi-annual, or annual basis is of sufficient amount to affect the individual's
eligibility, it shall be prorated as a monthly amount and entered on the
Medicaid Eligibility Worksheet (Form PA-1E) accordingly. (See also
10:71-5.4(a)11,
regarding lump-sum payments.)
3. The period of income eligibility begins
with the month in which application is made and continues until the scheduled
redetermination, or until a change in status or income occurs which requires an
earlier redetermination. (See
10:71-8.1(a),
regarding determination of continuing eligibility.)
4. At the time of application, the applicant
shall identify any income which he or she receives periodically (less
frequently than once a month) or anticipates receiving prior to the time of
redetermination.
5. In situations
where earned or unearned income is received irregularly or in irregular
amounts, redetermination shall be made as frequently as necessary. The
individual shall be advised of his or her responsibility to report significant
changes in income. (See
10:71-5.3(a)12
regarding exclusion of certain irregular income.)
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