Commonwealth of Massachusetts
Executive Office of Health and Human Services
Office of Medicaid
600 Washington Street
Boston, MA  02111
www.mass.gov/masshealth


		MassHealth
		Eligibility Letter 158
		January 1, 2007

TO:	MassHealth Staff

FROM:	Beth Waldman, Medicaid Director

RE:	Annual Change to the Federal Standard Maintenance Allowance

This letter transmits revised regulations about the annual increase to the 
federal standard maintenance allowance from $1,604 to $1,650.  The revision to 
130 CMR 520.026(C)(2) was inadvertently omitted from Eligibility Letter 154, 
which changed this figure in the minimum-monthly-maintenance-needs allowance at 
130 CMR 520.026(B)(1)(a).

These emergency regulations are effective July 1, 2006.


MANUAL UPKEEP

Insert		Remove		Trans. By

520.026 (2 of 5)	520.026 (2 of 5)	E.L. 145


130 CMR:  DIVISION OF MEDICAL ASSISTANCE

Trans. by E.L. 158


Rev. 07/01/06

	MASSHEALTH
	FINANCIAL ELIGIBILITY

Chapter 520
Page 520.026 (2 of 5)


(c)  a dependent parent — a parent of either spouse who lives with the community 
spouse and who is claimed as a dependent by either spouse for income-tax 
purposes under the Internal Revenue Code; and

(d)  a dependent sibling — a brother or sister of either spouse (including a 
half-brother or half-sister) who lives with the community spouse and who is 
claimed as a dependent by either spouse for income-tax purposes under the 
Internal Revenue Code.

(2)  The deduction for family-maintenance needs is one-third of the amount by 
which the federal standard maintenance allowance exceeds the monthly gross 
income of the family member.  The federal standard maintenance allowance is 
$1,650.

(D)  Deductions for Maintenance of a Former Home.

(1)  MassHealth allows a deduction for maintenance of a home when a competent 
medical authority certifies in writing that a single individual, with no 
eligible dependents in the home, is likely to return home within six months 
after the month of admission.  This income deduction terminates at the end of 
the sixth month after the month of admission regardless of the prognosis to return home at that time.

(2)  The amount deducted is the 100 percent federal-poverty-level income 
standard for one person.

(E)  Deductions for Health-Care Coverage and Other Incurred Expenses.

(1)  Health-Insurance Premiums or Membership Costs.  The MassHealth agency 
allows a deduction for current health-insurance premiums or membership costs 
when payments are made directly to an insurer or a managed-care organization.

(2)  Incurred Expenses.

(a)  After the applicant is approved for MassHealth, the MassHealth agency will 
allow deductions for the applicant’s necessary medical and remedial-care 
expenses.  These expenses must not be payable by a third party.  These expenses 
must be for medical or remedial-care services recognized under state law but not 
covered by MassHealth.  

(b)  These expenses must be within reasonable limits as established by the 
MassHealth agency.  The MassHealth agency considers expenses to be within 
reasonable limits provided they are:

(i)  not covered by the MassHealth per diem rate paid to the long-term-care 
facility; and

(ii)  certified by a treating physician or other medical provider as being 
medically necessary.