2020 Dual Eligible Standards

(Based on Percentage of Federal Poverty Level)

Qualified Medicare Beneficiary (QMB):

Monthly Income Limits: (100% FPL + $20)* $ 1,084 - Individual $1,457 - Couple

Asset Limits: $7,860 - Individual $11,800 - Couple

Specified Low-Income Medicare Beneficiary (SLMB):

Monthly Income Limits: (120% FPL + $20)* $1,296 - Individual $1,744 - Couple

Asset Limits: $7,860 - Individual $11,800 - Couple

Qualifying Individual (QI):

Monthly Income Limits: (135% FPL + $20)* $1,456 - Individual $1,960 - Couple

Asset Limits: $7,860 - Individual $11,800 - Couple

Qualified Disabled Working Individual (QDWI):

Monthly Income Limits: (400%FPL + $20) $4,339 - Individual $5,832 - Couple

(Figures include additional earned income disregards)

Asset Limits: $4,000 - Individual $6,000 - Couple

*$20 = Amount of the Monthly SSI Income Disregard

Schedule MA-1

Non-MAGI Medical Assistance Income Standards

Persons Dependent

On Income

Annual

Monthly

1 $4,200 $350

2 $4,700 $392

3 $5,200 $434

4 $5,700 $475

5 $6,252 $521

6 $6,876 $573

7 $7,740 $645

8 $8,508 $709

9 $9,192 $766

10 $9,912 $826

11 $10,632 $886

12 $11,352 $946

13 $12,048 $1,004

14 $12,756 $1,063

15 $13,488 $1,124

16 $14,208 $1,184

Each Additional

Person $732 $61

Schedule MA-1A

Non-MAGI Medical Assistance Income Standards

Consideration Periods

Persons

Dependent

On Income

6 Month

Consideration

Period

1 $2,100

2 $2,350

3 $2,600

4 $2,850

5 $3,126

6 $3,438

7 $3,870

8 $4,254

9 $4,596

10 $4,956

11 $5,316

12 $5,676

13 $6,024

14 $6,378

15 $6,744

16 $7,104

Each Additional

Person $366

Schedule MA-2

Non-MAGI Resource Standards

Persons Standard

1 $2,500

2 $3,000

3 $3,100

4 $3,200

5 $3,300

6 $3,400

7 $3,500

8 $3,600

Each Additional

Person $100

Schedule MA-3

Category and Scope Codes

Removed Effective April 1, 2004

Per Manual Release 116

(These codes were pre-CARES)

Schedule MA-4

List of Private Licensed Long-Term Care Facilities

Removed Effective April 1, 2004

Per Manual Release 116

Schedule MA-5

List of Licensed State Long-Term Care Facilities

Removed prior to 1997

MARYLAND MEDICAL ASSISTANCE PROGRAM

SCHEDULE MA-6

Average monthly amount payable for care in a skilled nursing facility

Effective Average

10/8/19 $9,673

Average daily amount payable for care in a skilled nursing facility

Effective Average

10/8/19 $318

Note: Based on the Genworth 2019 Cost of Care Survey, October 2019

https://www.genworth.com/about-us/industry-expertise/cost-of-care.html

Life Estate and Remainder Interest Table MA-7

AAggee LLiiffee EEssttaattee RReemmaaiinnddeerr AAgg ee Life Estate

RReemmaaiinnddeerr Age

LLiiffee EEssttaattee RReemmaaiinnddeerr

00 .97188 .02812 4422 .90457 .09543 8844 .36998 .63002 11 .98988 .01012 4433 .89855 .10145 8855 .35359 .64641 22 .99017 .00983 4444 .89221 .10779 8866 .33764 .66236 33 .99008 .00992 4455 .88558 .11442 8877 .32262 .67738 44 .98981 .01019 4466 .87863 .12137 8888 .30859 .69141 55 .98938 .01062 4477 .87137 .12863 8899 .29526 .70474 66 .98884 .01116 4488 .86374 .13626 9900 .28221 .71779 77 .98822 .01178 4499 .85578 .14422 9911 .26955 .73045 88 .98748 .01252 5500 .84743 .15257 9922 .25771 .74229 99 .98663 .01337 5511 .83674 .16126 9933 .24692 .75308 1100 .98565 .01435 5522 .82969 .17031 9944 .23728 .76272 1111 .98453 .01547 5533 .82028 .17972 9955 .22887 .77113 1122 .98329 .01671 5544 .81054 .18946 9966 .22181 .77819 1133 .98198 .01802 5555 .80046 .19954 9977 .21550 .78450 1144 .98066 .01934 5566 .79006 .20994 9988 .21000 .79000 1155 .97937 .02063 5577 .77931 .22069 9999 .20486 .79514 1166 .97815 .02185 5588 .76822 .23178 110000 .19975 .80025 1177 .97700 .02300 5599 .75675 .24325 110011 .19532 .80468 1188 .97590 .02410 6600 .74491 .25509 110022 .19054 .80946 1199 .97480 .02520 6611 .73267 .26733 110033 .18437 .81563 2200 .97365 .02635 6622 .72002 .27998 110044 .17856 .82144 2211 .97245 .02755 6633 .70696 .29304 110055 .16962 .83038 2222 .97120 .02880 6644 .69352 .30648 110066 .15488 .84512 2233 .96986 .03014 6655 .67970 .32030 110077 .13409 .86591 2244 .96841 .03159 6666 .66551 .33449 110088 .10068 .89932 2255 .96678 .03322 6677 .65098 .34902 110099 .04545 .95455 2266 .96495 .03505 6688 .63610 .36390

2277 .96290 .03710 6699 .62086 .37914

2288 .96062 .03938 7700 .60522 .39478

2299 .95813 .04187 7711 .58914 .41086

3300 .95543 .04457 7722 .57261 .42739

3311 .95254 .04746 7733 .55571 .44429

3322 .94942 .05058 7744 .53862 .46138

3333 .94608 .05392 7755 .52149 .47851

3344 .94250 .05750 7766 .50441 .49559

3355 .93868 .06132 7777 .48742 .51258

3366 .93460 .06540 7788 .47049 .52951

3377 .93026 .06974 7799 .45357 .54643

3388 .92567 .07433 8800 .43659 .56341

3399 .92083 .07917 8811 .41967 .58033

4400 .91571 .08429 8822 .40295 .59705

4411 .91030 .08970 8833 .38642 .61358 26 CFR 20.2031-7, 49 Federal Register

Schedule MA-8

Spousal Impoverishment Standards

Resources Effective

Maximum Spousal Share $128,640 1/1/20

Minimum Spousal Share $ 25,728 1/1/20

Income Effective

Basic Maintenance and Shelter Allowance $2,114 7/1/19

Excess Shelter Standard $ 635 7/1/19

Maximum Maintenance and Shelter Allowance $3,216 1/1/20

(sum of Basic Maintenance and Shelter

Allowance and Excess Shelter Allowance)

Utility Standards: (used to compute the community spouse’s excess shelter allowance)

Heat included in rent (LUA) $ 240 1/1/20

(Food Stamps limited utility allowance)

Heat paid separately from housing (SUA) $ 392 1/1/20

(Food Stamps standard utility allowance)

SSI Payment Rate

Income Effective

Individual $ 783 1/1/20

Couple $ 1,175 1/1/20

Substantial Gainful Activity (SGA) Limit: $1,260 1/1/20

(If Blind: $2,110)

Personal Needs Allowance (PNA)

Income Effective

Individual $ 82 7/1/19

Couple $ 164 7/1/19

MARYLAND MEDICAL ASSISTANCE PROGRAM

Schedule MA 9-A

Period Life Table, 2015

EExxaacctt

AAggee MMaallee LLiiffee

EExxppeeccttaannccyy FFeemmaallee LLiiffee

EExxppeeccttaannccyy EExxaacctt

AAggee MMaallee LLiiffee

EExxppeeccttaannccyy FFeemmaallee LLiiffee

EExxppeeccttaannccyy 0 76.15 80.97 38 40.38 44.30

1 75.63 80.41 39 39.46 43.35 2 74.67 79.44 40 38.54 42.41 3 73.69 78.45 41 37.63 41.46 4 72.71 77.47 42 36.72 40.52 5 71.72 76.48 43 35.81 39.59 6 70.73 75.48 44 34.90 38.65 7 69.74 74.49 45 34.00 37.72 8 68.75 73.50 46 33.11 36.80 9 67.76 72.51 47 32.22 35.88

10 66.76 71.51 48 31.34 34.96 11 65.77 70.52 49 30.46 34.06 12 64.78 69.53 50 39.60 33.15 13 63.79 68.53 51 28.75 32.26 14 62.80 67.54 52 27.90 31.37 15 61.82 66.56 53 27.07 30.49 16 60.84 65.57 54 26.25 29.61 17 59.88 64.59 55 25.43 28.74 18 58.91 63.61 56 24.63 27.88 19 57.96 62.63 57 23.83 27.02 20 57.01 61.65 58 23.05 26.17 21 56.08 60.67 59 22.27 25.32 22 55.14 59.70 60 21.51 24.48 23 54.22 58.73 61 20.75 23.64 24 53.29 57.76 62 20.00 22.81 25 52.37 56.79 63 19.27 21.99 26 51.44 55.82 64 18.53 21.17 27 50.52 54.85 65 17.81 20.36 28 49.59 53.88 66 17.09 19.55 29 48.67 52.92 67 16.38 18.76 30 47.75 51.95 68 15.68 17.98 31 46.82 50.99 69 14.98 17.20 32 45.90 50.03 70 14.30 16.44 33 44.98 49.07 71 13.63 15.69 34 44.06 48.11 72 12.97 14.96 35 43.14 47.16 73 12.33 14.24 36 42.22 46.20 74 11.70 13.54 37 41.30 45.25 75 11.08 12.85

MARYLAND MEDICAL ASSISTANCE PROGRAM

Schedule MA 9-A

Period Life Table, 2015

EExxaacctt

AAggee MMaallee LLiiffee

EExxppeeccttaannccyy FFeemmaallee LLiiffee

EExxppeeccttaannccyy EExxaacctt

AAggee MMaallee LLiiffee

EExxppeeccttaannccyy FFeemmaallee LLiiffee

EExxppeeccttaannccyy 76 10.48 12.17 98 2.34 2.73

77 9.89 11.51 99 2.22 2.57 78 9.33 10.86 100 2.11 2.42 79 8.77 10.24 101 2.00 2.27 80 8.24 9.63 102 1.89 2.14 81 7.72 9.04 1.79 2.00 2.06 82 7.23 8.48 104 1.69 1.88 83 6.75 7.93 105 1.59 1.76 84 6.30 7.41 106 1.50 1.64 85 5.87 6.91 107 1.41 1.53 86 5.45 6.43 108 1.33 1.43 87 5.06 5.98 109 1.25 1.33 88 4.69 5.54 110 1.17 1.24 89 4.35 5.14 111 1.10 1.15 90 4.03 4.76 112 1.03 1.06 91 3.73 4.41 113 0.96 0.98 92 3.46 4.09 114 0.89 0.90 93 3.21 3.80 115 0.83 0.83 94 2.99 3.54 116 0.77 0.77 95 2.80 3.30 117 0.71 0.71 96 2.63 3.09 118 0.66 0.66 97 2.48 2.90 119 0.61 0.61

Notes:

The period life expectancy at a given age for 2015 represents the average number of years of life remaining if a

group of persons at that age were to experience the mortality rates for 2015 over the course of their remaining life.

For updates, see: http://www.ssa.gov/OACT/STATS/table4c6.html

Source: SSA, Estimates from the 2016 Trustees Report

Schedule MA-10

Excess Home Equity Limit

For Exclusion of Long-Term Care Coverage

Excess Home Equity Limit Effective Date

$595,000 2020