New York Codes, Rules and Regulations
Title 18 - DEPARTMENT OF SOCIAL SERVICES
Chapter II - Regulations of the Department of Social Services
Subchapter B - Public Assistance
Article 2 - Determination of Eligibility-Categorical
Part 360 - MEDICAL ASSISTANCE
Subpart 360-4 - Financial Eligibility
Section 360-4.6 - Net available income and resources

Current through Register Vol. 46, No. 39, September 25, 2024

Not all of the income and resources available to an applicant/recipient is counted in determining his/her financial eligibility for MA. Certain types and amounts of income and resources are disregarded. After these disregards have been applied, what remains is the applicant'/recipient' net available income and resources. This section lists the types and amounts of income and resource disregards.

(a) Income disregards.

(1) Disregards applicable to all MA applicants/recipients:
(i) any payment received under title II of the Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970;

(ii) any loan made to a family under title III of the Federal Economic Opportunity Act;

(iii) Federal energy assistance payments;

(iv) payments received by foster parents for care of foster children;

(v) the value of garden produce or livestock when used solely by the applicant/recipient and dependents;

(vi) the value of free school lunches;

(vii) the value of other free meals, except when more than one meal per day is furnished or when the applicant/recipient receives an allowance for meals away from home;

(viii) the value of food stamp coupons;

(ix) the value of federally donated foods;

(x) the value of WIC benefits;

(xi) payments made to participants in the Retired Senior Volunteer Program under the Domestic Volunteer Services Act for services provided to adults who have exceptional needs;

(xii) payments made to participants in the Foster Grandparent Program under the Domestic Volunteer Services Act;

(xiii) payments made to compensate for expenses incident to employment under subparagraph (xi) or (xii) of this paragraph;

(xiv) payments made to volunteers under the VISTA program;

(xv) any funds received by an applicant/recipient from the department of Housing and Urban Development community development block grants;

(xvi) any support and maintenance provided based on need according to section 352.22(s) of this Title;

(xvii) income from roomers/boarders. The first $90 per month of any income received from a person living in the home who is not a member of the family household. If the family can document out-of-pocket expenses greater than $90 per month incurred in providing room and board, these documented expenses will be disregarded;

(xviii) any portion of a grant, scholarship or fellowship used for tuition, fees, or other necessary educational expenses (excluding general living expenses);

(xix) regular cash assistance payments based on need and furnished as supplemental income by the Federal government, a state or political subdivision;

(xx) payments provided as a preventive housing service under section 423.4(1) of this Title;

(xxi) benefits paid to eligible Japanese-Americans or Aleuts under the Federal Civil Liberties Act of 1988 and the Aleutian and Pibilof Islands Restitution Act;

(xxii) payments made from the Agent Orange Settlement Fund or any other fund established pursuant to the settlement in the In re Agent Orange product liability litigation, and payments received from court proceedings brought for personal injuries sustained by veterans resulting from exposure to dioxin or phenoxy herbicides in connection with the war in Indochina in the period of January 1, 1962 through May 7, 1975;

(xxiii) refunds or advance payments of the Federal Earned Income Tax Credit;

(xxiv) payments made for child care services, or the value of any child care services provided to a recipient of employment-related and JOBS-related child care services, transitional child care services, at-risk low income child care services or child care and development block grant services;

(xxv) bona fide loans, as described in section 352.22 of this Title;

(xxvi) any Federal major disaster and emergency assistance provided under the Disaster Relief Act of 1974 ( P.L. 93-288), as amended by the Disaster Relief and Emergency Assistance Amendments of 1988 ( P.L. 100-707), and any comparable disaster assistance provided by states, local governments, and disaster assistance organizations;

(xxvii) distributions to Native Americans of funds appropriated in satisfaction of judgments of the Indian Claims Commission or the United States Court of Federal Claims;

(xxviii) up to $2,000 per year of income from interests of individual Native Americans in trust or restricted lands, from funds appropriated in satisfaction of Indian Claims Commission or United States Court of Federal Claims; and

(xxix) any other income that a Federal law or regulation requires to be disregarded.

(2) Additional disregards applicable to MA applicants/recipients who are 65 years of age or older, certified blind or certified disabled. These disregards are to be applied in the following order:
(i) [Reserved]

(ii) all reparations payments received from the Federal Republic of Germany;

(iii) the first $20 per month of any unearned income. Only one $20 disregard is permitted per couple. A certified blind or certified disabled child living with parents is entitled to a separate $20 disregard from his/her total unearned income. If a person' unearned income is under $20, the balance will be deducted from earned income;

(iv) the first $65 of earned income;

(v) for disabled MA applicants/recipients, nonmedical, impairment-related work expenses;

(vi) one half of the remaining earned income after the disregards listed in subparagraphs (ii)-(v) of this paragraph have been applied;

(vii) health insurance premiums;

(viii) aid and attendance benefits and housebound benefits received from the Veterans' Administration;

(ix) any refund received from a public agency of taxes paid on real estate or food purchases;

(x) infrequently or irregularly received income up to $20 of unearned income per month and $10 of earned income per month;

(xi) for persons who are certified blind, all remaining reasonable work-related expenses, after the disregards set forth in subparagraphs (i)-(xi) of this paragraph are applied;

(xii) one third of any support payments received by a certified blind or certified disabled child from an absent parent;

(xiii) any payments made under the Federal Vocational Rehabilitation Act;

(xiv) income, up to $1,200 per calendar quarter but not more than $1,620 per calendar year, earned by a child under 22 years of age who is regularly attending a school, college, university, or a course of vocational or technical training;

(xv) [Reserved]

(xvi) home energy assistance payments which are based on financial need;

(xvii) interest earned on excluded burial funds and appreciation in the value of an excluded burial arrangement which are to become part of the separately identifiable burial fund;

(xviii) any assistance to an inparaidual (other than wages or salaries) under the Federal Older Americans Act of 1965;

(xix) retroactive benefits under the SSI program;

(xx) payments received from a fund established by a state to aid victims of crime;

(xxi) relocation assistance received on or after May 1, 1991 that is provided by a state or local government and is comparable to assistance provided under title II of the Uniform Relocation Assistance and Real Property Acquisitions Policies Act of 1970 which is subject to the treatment required by section 216 of such Act;

(xxii) payments made by the Austrian government under paragraphs 500 to 506 of the Austrian General Social Insurance Act provided that the payments remain identifiable as such;

(xxiii) income received from hostile fire pay (pursuant to section 310 of title 37, United States Code) received while in active military service; and

(xxiv) for certified blind or certified disabled persons under 65 years of age, and for certified blind or certified disabled persons age 65 or over who received SSI payments or aid under the State Plan for the certified blind or certified disabled for the month preceding the month of their 65th birthday, any remaining countable income may be set aside for a plan to achieve self-support. The plan must:
(a) be current, in writing and approved by the local commissioner of social services for not more than 18 months, with the possibility of an extension for an additional 18 months. A second extension for an additional 12 months may be allowed in order to fulfill a lengthy educational or training program;

(b) specify planned savings and/or expenditures to achieve a designated feasible occupational objective and a specific period of time to achieve the objective;

(c) provide for the identification and segregation of money and goods, if any, being accumulated and saved; and

(d) be followed by the individual.

(3) Additional disregards applicable to needy individuals under 21, pregnant women, persons ineligible for ADC solely because their income and resources exceed the ADC eligibility standards, parents described in section 360- 3.3(b)(7) of this Part. These disregards are to be applied in the following order:
(i) the first $90 of earned income;

(ii) all of the earned income of a child under 21 who is attending a school, college or university or vocational or technical training designed to prepare a person for gainful employment will be disregarded if the student is employed part-time. If a full-time student is employed full-time, his/her income will be disregarded for up to six months in a calendar year;

(iii) after the disregards in subparagraphs (i) and (ii) of this paragraph have been applied, $30 plus one third of the remainder of monthly earned income will be disregarded for four consecutive months, and $30 per month will be disregarded for an additional eight months after that. This disregard will apply only if:
(a) the applicant received ADC payments in one of the four preceding months;

(b) the period of four consecutive months in which the $30 plus one-third disregard is applied includes any period in which the disregard was applied under the ADC program according to section 352.20 of this Title;

(c) the additional eight-month period begins with the month following the fourth consecutive month that the $30 plus one-third disregard was applied, and ends with the eighth consecutive month regardless of whether the $30 disregard is actually applied to the person's earned income; and

(d) except as provided in this subparagraph, the disregard is applied in the same manner and subject to the same restrictions as the disregard provided to ADC applicants. Section 352.20(c), (d) and (e) of this Title explain the ADC disregard;

(iv) for individuals employed full-time throughout the month, an amount equal to the actual cost, but not to exceed $175, for the case of each dependent child two years of age or older or incapacitated adult living in the same home and receiving assistance, and an amount equal to the actual cost, but not to exceed $200, for the care of each dependent child under two years of age living in the same home and receiving assistance; for those individuals working less than full-time or not employed throughout the month, an amount equal to the actual cost, but less than $175 for the care of each dependent child two years of age or older or incapacitated adult, and an amount equal to the actual cost, but less than $200, for each dependent child under two years of age;

(v) the first $50 of any child or spousal support payments received in a month;

(vi) money received by a family based on the enrollment of a youth in the Job Corps under the Job Training Partnership Act;

(vii) health insurance premiums; and

(viii) for a person providing family day care for children other than his/her own, $5 per day for each such child.

(b) Resource disregards.

(1) Burial funds of MA applicants/recipients and their families will be disregarded as follows:
(i) for needy individuals under 21 years of age and persons ineligible for ADC solely because their income and resources are above eligibility limits, a burial fund will be disregarded if it is separately identifiable as a contractual funeral agreement with a maximum equity value of $1,500 per family member; and

(ii) for persons 65 years of age or older, certified blind or certified disabled, and for spouses of such persons, a burial fund of up to $1,500 will be disregarded if the funds are separately identifiable and monitored as a burial fund. Such burial fund will be made up first of any life insurance policies with a face value of $1,500 or less.

(2) For MA applicants/recipients who are 65 years of age or older, certified blind, or certified disabled, the following additional resources will be disregarded:
(i) all property which is contiguous to the applicant's/recipient's homestead. The term homestead is defined in section 360-1.4(f) of this Part. Contiguous property is the land adjoining the homestead and the buildings located on such land. To be considered contiguous, the land must adjoin the plot on which the home is located and must not be separated from it by intervening real property owned by others. Property will be considered to adjoin other property if the only intervening real property is an easement or public right-of-way such as a street, road, or utility line;

(ii) life insurance policies with a combined face value of $1,500 or less;

(iii) on or after September 1, 1987, pension funds belonging to an ineligible or nonapplying legally responsible relative which are held in individual retirement accounts or in work-related pension plans, including plans for self- employed individuals such as Keogh plans. However, amounts disbursed from a pension fund to a pensioner are income to the pensioner which will be considered in the deeming process;

(iv) reparation payments received from the Republic of Germany provided that the reparation payments remain identifiable as such;

(v) for a period of nine months following the month of receipt, retroactive SSI and social security benefits received during the period of October 1, 1987 through September 30, 1989; for a period of six months following the month of receipt, retroactive SSI and social security benefits received on or after October 1, 1989;

(vi) for a period of nine months following the month receipt, payments received from a fund established by a state to aid victims or crime;

(vii) for a period of nine months following the month of receipt, relocation assistance provided by a state or local government that is received on or after May 1, 1991 and is comparable to assistance provided under title II of the Uniform Relocation Assistance and Real Property Acquisitions Policies Act of 1970 which is subject to the treatment required by section 216 of such act; and

(viii) payments made by the Austrian government under paragraphs 500 to 506 of the Austrian General Social Insurance Act provided that the payments remain identifiable as such.

(3) For certified blind or certified disabled MA applicants/recipients under 65 years of age, and for certified blind or certified disabled MA applicants/recipients age 65 or over who received SSI payments or aid under the State Plan for the blind or disabled for the month preceding the month of their 65th birthday, any remaining countable resources may be set aside for a plan to achieve self-support in accordance with the provisions of subparagraph (a)(2)(xxi) of this section.

(4) For all MA applicants/recipients, payments provided as a preventive housing service under section 423.4(1) of this Title will be disregarded.

(5) A child's savings account of under $500 accumulated from gifts from nonlegally responsible relatives or from the child's own wages will be disregarded in determining eligibility.

(6) Benefits received by eligible Japanese-Americans or Aleuts under the Federal Civil Liberties Act of 1988 or the Aleutian and Pribilof Islands Restitution Act will be disregarded.

(7) For all MA applicants/recipients, payments provided from the Agent Orange Settlement Fund, from any other fund established pursuant to the settlement in the In re Agent Orange product liability litigation, or from court proceedings brought for personal injuries sustained by veterans resulting from exposure to dioxin or phenoxy herbicides in connection with the war in Indochina in the period of January 1, 1962 through May 7, 1975, will be disregarded.

(8) For all MA applicants/recipients, any payment received under title II of the Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970.

(9) For all MA applicants/recipients, for the month of receipt and the following month, refunds or advance payments of the Federal Earned Income Tax Credit.

(10) For needy individuals under the age of 21, pregnant women, persons ineligible for ADC solely because their income and resources exceed the ADC eligibility standards, and parents described in section 360-3.3(b)(7) of this Part, bona fide loans will be disregarded. Bona fide loans are described in section 352.22 of this Title.

(11) Any Federal major disaster and emergency assistance provided under the Disaster Relief Act of 1974 ( P.L. 93-288), as amended by the Disaster Relief and Emergency Assistance Amendments of 1988 ( P.L. 100-707), and any comparable disaster assistance provided by states, local governments, and disaster assistance organizations will be disregarded.

(12) For all MA applicants/recipients, interests of individual Native Americans in trust or restricted lands, from funds appropriated in satisfaction of judgments of the Indian Claims Commission or the United States Court of Federal Claims will be disregarded in determining eligibility.

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