22-02 Version of 39.4 Elderly, Blind, or Disabled Assets and Income Tables
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State of Wisconsin
Department of Health Services

HISTORY

The policy on this page is from a previous version of the handbook. 

22-02 Version of 39.4 Elderly, Blind, or Disabled Assets and Income Tables

  1. 39.4.1 Elderly, Blind, or Disabled Assets and Income Table
  2. 39.4.2 Disabled Minors Deeming and Allowances
  3. 39.4.3 LTC Post-Eligibility Allowances
  4. 39.4.4 LTC Spousal Impoverishment Post-Eligibility Allowances and Community Spouse Asset Share
  5. 39.4.5 Family Care, Family Care Partnership, or PACE Group B Plus Cost Share Cap
  6. 39.4.6 Institutional Cost of Care Values
  7. 39.4.7 SSI Reference Values

39.4.1 Elderly, Blind, or Disabled Assets and Income Table

Category Limit Group Size 1 Group Size 2 Effective Updated Annually?
SSI-Related Categorically Needy Asset $2,000.00 $3,000.00 1/1/1989 No
Income $924.78 $1,393.05 1/1/2022 Yes
SSI-Related Medically Needy Asset $2,000.00 $3,000.00 1/1/1989 No
Income $1,132.50 $1,525.83 2/1/2022 Yes
MAPP Asset $15,000.00 N/A 3/1/2000 No
Income Less than 250% FPL (see Section 39.5 FPL Table) 2/1/2022 Yes
Institutions Categorically Needy Income $2,523.00 N/A 1/1/2022 Yes
Group B Community Waivers Income $2,523.00 N/A 1/1/2022 Yes
QMB Asset $8,400.00 $12,600.00 1/1/2022 Yes
Income At or below 100% FPL (see Section 39.5 FPL Table) 2/1/2022 Yes
SLMB Asset $8,400.00 $12,600.00 1/1/2022 Yes
Income At least 100% FPL but less than 120% FPL (see Section 39.5 FPL Table) 2/1/2022 Yes
SLMB+ Asset $8,400.00 $12,600.00 1/1/2022 Yes
Income At least 120% FPL but less than 135% FPL (see Section 39.5 FPL Table) 2/1/2022 Yes
QDWI Asset $4,000.00 $6,000.00 7/1/1990 No
Income $2,265.00 $3,051.66 2/1/2022 Yes

39.4.2 Disabled Minors Deeming and Allowances

Item Amount Effective Updated Annually?
SSI-Related Deeming Amount to an Ineligible Minor $420.00 1/1/2022 Yes
Parental living allowance - 1 Parent $841.00 1/1/2022 Yes
Parental living allowance - 2 Parents $1,261.00 1/1/2022 Yes

39.4.3 LTC Post-Eligibility Allowances

Item Amount Effective Updated Annually?
Institutions Personal Needs Allowance $45.00 7/1/2001 No
Institutions Home Maintenance Allowance Maximum $1,020.77 1/1/2022 Yes
Non-Spousal-Impoverishment Family Maintenance Allowance Maximum $1,020.77 1/1/2022 Yes
Community Waivers Basic Needs Allowance $1,021.00 1/1/2022 Yes
Community Waivers Personal Maintenance Allowance Maximum $2,523.00 1/1/2022 Yes

39.4.4 LTC Spousal Impoverishment Post-Eligibility Allowances and Community Spouse Asset Share

Description Amount Effective Updated Annually?

Community Spouse Lower Income Allocation Limit

$3,051.66

 7/1/2022 Yes

Shelter Base Amount

$915.50

 7/1/2022 Yes

Community Spouse Income Allocation Maximum

$3,435.00

 1/1/2022 Yes
Dependent Family Member Income Allowance Maximum $762.92 7/1/2022 Yes
Dependent Family Member Income Allowance Standard

$2,288.75

 7/1/2022 Yes

Community Spouse Asset Share (CSAS) Maximum

$137,400

 1/1/2022 Yes

39.4.5 Family Care, Family Care Partnership, or PACE Group B Plus Cost Share Cap

Item Amount Effective Updated Annually?
Cost Share Cap for Group B Plus Family Care, Family Care Partnership, or PACE $3,228.27 1/1/2022 Yes

39.4.6 Institutional Cost of Care Values

Item Amount Effective Updated Annually?
Daily Average Private Pay Nursing Home Rate $307.40 1/1/2022 Yes
Monthly Average Private Pay Nursing Home Rate $9,350.08 1/1/2022 Yes
Monthly Rate for State Centers for Persons with Developmental Disabilities $28,028.96 1/1/2022 Yes

39.4.7 SSI Reference Values

Item Group Size 1 Group Size 2 Effective Updated Annually?
Federal SSI Payment Level $841.00 $1,261.00 1/1/2022 Yes
State Supplementary Payment (SSP) $83.78 $132.05 1994 No
SSI E Supplement $95.99 $345.36 1994 No
Substantial Gainful Activity Threshold for Non-Blind Disabled Individuals $1,350.00 N/A 1/1/2022 Yes
Substantial Gainful Activity Threshold for Blind Individuals $2,260.00 N/A 1/1/2022 Yes

 

This page last updated in Release Number: 22-02
Release Date: 08/01/2022
Effective Date: 08/01/2022

The information concerning the Medicaid program provided in this handbook release is published in accordance with: Titles XI and XIX of the Social Security Act; Parts 430 through 481 of Title 42 of the Code of Federal Regulations; Chapters 46 and 49 of the Wisconsin Statutes; and Chapters HA 3, DHS 2, 10 and 101 through 109 of the Wisconsin Administrative Code.

Notice: The content within this manual is the sole responsibility of the State of Wisconsin's Department of Health Services (DHS). This site will link to sites outside of DHS where appropriate. DHS is in no way responsible for the content of sites outside of DHS.

Publication Number: P-10030