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Update #20-05 Page 5-1 Charts 5. Medi-Cal Charts 5. Medi-Cal Charts 5.1 Federal Poverty Level Programs Monthly Income Comparison Chart 100% Qualified Medicare Beneficiary (QMB) Program FPL Program for Aged and Disabled 142% ACA and Title XXI Expansion Children Ages 1 - 6 108% ACA Title XXI CHIP Expansion Children Ages 6 - 19 160% ACA Optional Targeted Low Income Children (OTLIC) 109% ACA Parents and Caretaker Relatives 185% Transitional Medi-Cal (TMC) (Pre-ACA) 114% ACA Parents and Caretaker Relatives not eligible for the ACA Adult Group due to enrollment in Medicare Part A or B (109% FPL, Plus 5% MAGI Disregard) 200% Qualified Working Disabled Individuals Refugee Medical Assistance (RMA) 120% Specified Low Income Beneficiaries (SLMB) 208% ACA and Title XXI Expansion Infants Ages 0 - 1 128% Disabled Individuals in New Adult Group 213% ACA Pregnant Women, pregnancy related Medi-Cal 133% ACA Children and Title XXI Expansion Children Ages 6 - 19 250% Working Disabled Program (WDP) 135% Qualified Individual 1 (QI-1) Program 266% ACA OTLIC (Premiums) 138% ACA New Adult Group Ages 19 - 64 Full-scope coverage for ACA Pregnant Women 322% ACA MCAP Linked Infants County Children’s Health Initiative Program (CCHIP) Above 138% - 213% FPL = Pregnancy Related Medi-Cal Above 213% - 322% FPL = Medi-Cal Access Program (MCAP), Medi-Cal Access Infant Program (MCAIP) Above 266% - 322% FPL = CCHIP Population Affected FPL Effective Date MAGI applicants/recipients, MSP applicants/recipients that do not receive RSDI Title II income January 1, 2020 MSP applicants/recipients that receive RSDI Title II income March 1, 2020 ABD applicants/recipients, all other MC programs April 1, 2020

Transcript of 5.1 Federal Poverty Level Programs Monthly Income ... · Medi-Cal Page 5-1 Update #20-05 Charts 5....

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5. Medi-Cal Charts

5.1 Federal Poverty Level ProgramsMonthly Income Comparison Chart

100% • Qualified Medicare Beneficiary (QMB) Program

• FPL Program for Aged and Disabled

142% ACA and Title XXI Expansion Children Ages 1 - 6

108% ACA Title XXI CHIP Expansion Children Ages 6 - 19

160% ACA Optional Targeted Low Income Children (OTLIC)

109% ACA Parents and Caretaker Relatives 185% Transitional Medi-Cal (TMC) (Pre-ACA)

114% ACA Parents and Caretaker Relatives not eligible for the ACA Adult Group due to enrollment in Medicare Part A or B (109% FPL, Plus 5% MAGI Disregard)

200% • Qualified Working Disabled Individuals

• Refugee Medical Assistance (RMA)

120% Specified Low Income Beneficiaries (SLMB) 208% ACA and Title XXI Expansion Infants Ages 0 - 1

128% Disabled Individuals in New Adult Group 213% ACA Pregnant Women, pregnancy related Medi-Cal

133% ACA Children and Title XXI Expansion Children Ages 6 - 19

250% Working Disabled Program (WDP)

135% Qualified Individual 1 (QI-1) Program 266% ACA OTLIC (Premiums)

138% • ACA New Adult Group Ages 19 - 64• Full-scope coverage for ACA Pregnant

Women

322% • ACA MCAP Linked Infants • County Children’s Health Initiative

Program (CCHIP)

• Above 138% - 213% FPL = Pregnancy Related Medi-Cal• Above 213% - 322% FPL = Medi-Cal Access Program (MCAP), Medi-Cal Access Infant Program

(MCAIP)• Above 266% - 322% FPL = CCHIP

Population Affected FPL Effective Date

MAGI applicants/recipients, MSP applicants/recipients that do not receive RSDI Title II income

January 1, 2020

MSP applicants/recipients that receive RSDI Title II income March 1, 2020

ABD applicants/recipients, all other MC programs April 1, 2020

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2020 F

FamilySize

ACA Adults Ages 19-64 & Pregnant Women

ACA Children Ages 1-6

TLICP (Pre-ACA)

138% 142% 150%

1 1468 1510 1596

2 1983 2041 2155

2 Adults 1983 2041 2155

3 2498 2571 2715

4 3013 3101 3276

5 3529 3631 3835

6 4044 4161 4395

7 4559 4691 4956

8 5074 5221 5515

9 5589 5751 6075

10 6105 6282 6636

11 6620 6812 7195

12 7135 7342 7755

Ea Add’l

+516 +531 +561

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Chart

PL CALCULATION CHART (Monthly Values)

Eligible for Advanced Premium Tax Credit (APTC) (100% to 400%)

Enhanced Silver Benefits/Cost-Sharing Reduction (CSR) 94% (100% to 150% FPL)

Children Ages 6-19 A&D FPL QMB

Children Ages 6-19 ACA Expansion

ACA Parents/Caretaker Relatives

ACA Parents/Caretaker Relatives enrolled in Medicare Part A/B

SLMBDisabled Individuals Adult Group

Children Ages 1-6 ACAExpansion

QI-1 Program

100% 108% 109% 114% 120% 128% 133% 135%

1064 1149 1160 1213 1276 1362 1415 1436

1437 1552 1566 1638 1724 1839 1911 1940

1437 1552 1566 1638 1724 1839 1911 1940

1810 1955 1973 2064 2172 2317 2408 2444

2184 2358 2380 2489 2620 2795 2904 2948

2557 2762 2787 2915 3068 3273 3401 3452

2930 3165 3194 3341 3516 3751 3897 3956

3304 3568 3601 3766 3964 4229 4394 4460

3677 3971 4008 4192 4412 4707 4890 4964

4050 4374 4415 4617 4860 5184 5387 5468

4424 4778 4822 5043 5308 5662 5884 5972

4797 5181 5229 5469 5756 6140 6380 6476

5170 5584 5636 5894 6204 6618 6877 6980

+374 +404 +407 +426 +448 +478 +497 +504

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202

FamSiz

A OTLIC

ACA MCAP Infants & CCHIP

266% 322% 400%

2829 3424 4254

3822 4627 5747

2 A 3822 4627 5747

4815 5829 7240

5808 7031 8734

6801 8233 10227

7794 9435 11720

8787 10637 13214

9780 11839 14707

10773 13041 16200

11767 14244 17694

12760 15446 19187

13753 16648 20680

Ea +994 +1203 +1494

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Chart

0 FPL CALCULATION CHART (Monthly Values)

ily e

Eligible for Advanced Premium Tax Credit (APTC) (100% to 400%)

Enhanced Silver Benefits/Cost-Sharing Reduction (CSR)

87% (>150% to 200% FPL) 73% (> 200% to 250% FPL)

ACA OTLICTMC (Pre-ACA)

Qualified WD Indiv. RMA

ACA Infants Ages 0-1

ACA Pregnant Women & Infants up to Age 1

WDP AC

160% 185% 200% 208% 213% 250%

1 1702 1968 2127 2212 2265 2659

2 2299 2658 2874 2989 3061 3592

dults 2299 2658 2874 2989 3061 3592

3 2896 3349 3620 3765 3856 4525

4 3494 4040 4367 4542 4651 5459

5 4091 4730 5114 5318 5446 6392

6 4688 5421 5860 6095 6241 7325

7 5286 6112 6607 6871 7037 8259

8 5883 6802 7354 7648 7832 9192

9 6480 7493 8100 8424 8627 10125

10 7078 8184 8847 9201 9422 11059

11 7675 8874 9594 9978 10217 11992

12 8272 9565 10340 10754 11013 12925

Add’l +598 +691 +747 +777 +796 +934

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Note:

Compare the monthly net non-exempt income of the entire family (AFDC-MN/MI MFBU with no Sneede Class Members), after adding back any deduction for private health coverage. Only AFDC-MN/MI deductions are allowed.Contact the Medi-Cal Program Coordinator if prior FPL amounts are needed

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5.2 Property Limits

Table 5-1: Property Limit Chart

Number of individuals Whose Property is Considered

Property Limit 1985

Property Limit 1986

Property Limit 1987

Property Limit 1988

Property Limit 1989-Present

1 individual $1,600 $1,700 $1,800 $1,900 $2,000

2 individuals 2,400 2,550 2,700 2,850 3,000

3 individuals 2,550 2,700 2,850 3,000 3,150

4 individuals 2,700 2,850 3,000 3,150 3,300

5 individuals 2,850 3,000 3,150 3,300 3,450

6 individuals 3,000 3,150 3,300 3,450 3,600

7 individuals 3,150 3,300 3,450 3,600 3,750

8 individuals 3,300 3,450 3,600 3,750 3,900

9 individuals 3,450 3,600 3,750 3,900 4,050

10 or more individuals

3,600 3,750 3,900 4,050 4,200

5.3 Community Spouse Resource Allowance (CSRA)

Table 5-2: CSRA Chart

Effective Date CSRA Effective Date CSRA

1/1/20 $128,640 1/1/07 $101,640

1/1/19 $126,420 1/1/06 $99,540

1/1/18 $123,600 1/1/05 $95,100

1/1/17 $120,900 1/1/03 $90,660

1/1/15 $119,220 1/1/02 $89,280

1/1/14 $117,240 1/1/01 $87,000

1/1/13 $115,920 1/1/00 $84,120

1/1/12 $113,640 1/1/99 $81,960

1/1/09-11 $109,560 1/1/98 $80,760

1/1/08 $104,400 1/1/97 $79,020

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5.4 Community Spouse Income Allocation (CSIA)

Table 5-3: CSIA Chart

Effective Date Amount Effective Date Amount

2020 $3,216 2009-11 $2,739

2019 $3,161 2008 $2,610

2018 $3,090 2007 $2,541

2017 $3,023 2006 $2,489

2015 $2,981 2005 $2,378

2014 $2,931 2004 $2,319

2013 $2,898 2003 $2,267

2012 $2,841 2002 $2,232

5.5 Family Member Base Allocation (FMBA)

Table 5-4: FMBA Chart

Effective Date Amount

7/1/19 - 6/30/20 $2,114

7/1/18 - 6/30/19 $2,058

7/1/17 - 6/30/18 $2,030

7/1/16 - 6/30/17 $2,003

7/1/15 - 6/30/16 $1,991

7/1/14 - 6/30/15 $1,967

7/1/13 - 6/30/14 $1,939

7/1/12 - 6/30/13 $1,891

7/1/11 - 6/30/12 $1,839

7/1/09 - 6/30/11 $1,822

7/1/08 - 6/30/09 $1,750

7/1/07 - 6/30/08 $1,712

7/1/06 - 6/30/07 $1,650

7/1/05 - 6/30/06 $1,604

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Contact the Medi-Cal Program Coordinator if a base allocation for prior years is needed.

5.6 Statewide Average Private Pay Rate (APPR)

Year APPR Year APPR Year APPR

2020 $10,298 2008 $5,496 1996 $3,262

2019 $9,337 2007 $5,101 1995 $3,211

2018 $8,841 2006 $5,031 1994 $3,031

2017 $8,515 2005 $4,812 1993 $2,911

2016 $8,189 2004 $4,477 1992 $2,791

2015 $8,092 2003 $4,415 1991 $2,628

2014 $7,628 2002 $4,322

2013 $7,549 2001 $4,163

2012 $7,092 2000 $3,836

2011 $6,840 1999 $3,882

2010 $6,311 1998 $3,460

2009 $5,698 1997 $3,402

7/1/04 - 6/30/05 $1,562

7/1/03 - 6/30/04 $1,515

7/1/02 - 6/30/03 $1,493

7/1/01 - 6/30/02 $1,452

7/1/00 - 6/30/01 $1,407

7/1/99 - 6/30/00 $1,383

7/1/98 - 6/30/99 $1,357

7/1/97 - 6/30/98 $1,327

7/1/96 - 6/30/97 $1,295

7/1/95 - 6/30/96 $1,254

7/1/94 - 6/30/95 $1,230

Table 5-4: FMBA Chart

Effective Date Amount

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5.7 Maintenance Need (Effective 7/1/89)

Table 5-5: Current Maintenance Need Chart

Number of individuals in MFBU Maintenance Need

1 individual in all situations $600

1 adult and 1 child 750

2 adults 934

3 individuals 934

4 individuals 1,100

5 individuals 1,259

6 individuals 1,417

7 individuals 1,550

8 individuals 1,692

9 individuals 1,825

10 individuals 1,959

For each additional individual add $14.00.

The maintenance need level for MC recipients in LTC is $35.00.

The maintenance need level for SSI recipients in LTC is $50.00.

The home upkeep allowance for a single person is $209.00.

The home upkeep allowance in all other situations is $138.00.

Note:

For maintenance needs prior to July 1, 1989, contact a MC Program Coordinator.

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5.8 Medicare Savings Program (MSP) Income Limits and Property Limits

5.8.1 MSP Income Limit

QMB income limitSLMB income limitQI income limit

===

Less than or Equal to 100% of Federal Poverty LevelLess than 120% of Federal Poverty LevelLess than or Equal to 135% of Federal Poverty Level

5.8.2 MSP Income Disregard

QMB/SLMB/QI eligible individuals receive a $20 income disregard.

5.8.3 MSP Property Limits

MSP Property Limit Chart

Year Individual Couple

2020 $7,860 $11,800

2019 $7,730 $11,600

2018 $7,560 $11,340

2017 $7,390 $11,090

2016 $7,280 $10,930

2015 $7,160 $10,750

2014 $7,160 $10,750

2013 $7,080 $10,620

2012 $6,940 $10,410

2011 $6,680 $10,020

2010 $6,600 $9,910

Contact the Medi-Cal Program Coordinator if prior year income limits are needed.

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5.8.4 QMB/SLMB Standard Allocation (SSI Standard Allocation)

Table 5-6: Standard Allocation Chart

Effective Date Amount Effective Date Amount

2020 $392

2019 $386 2008 $319

2017 $368 2007 $311

2015-16 $367 2006 $301

2014 $361 2005 $290

2013 $356 2004 $282

2012 $350 2003 $277

2009-11 $337 2002 $272

2008 $319 2001 $266

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5.9 Federal Benefit Rate (FBR)

Table 5-7: FPB Chart

FBR Individual Couple

2020 $783 $1,175

2019 $771 $1,157

2018 $750 $1,125

2017 $735 $1,103

2015-2016 $733 $1,100

2014 $721 $1,082

2013 $710 $1,066

2012 $698 $1,048

2009 - 2011 $674 $1,011

2008 $637 $956

2007 $623 $934

2006 $603 $904

2005 $579 $869

2004 $564 $846

2003 $552 $829

2002 $545 $817

5.10 Tuberculosis (TB) Program Income and Property Limits

5.10.1 TB Program Monthly Income Limits

Table 5-8: TB Program Income Limit Chart

Standard for Individuals (Whether Married or Unmarred)

2019 2018 20172015-2016

2014 2013 20122009-2011

2008 2007

$1,627 $1,585 $1,555 $1,551 $1,527 $1,505 $1,481 $1,433 $1,359 1,331

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5.10.2 Tuberculosis (TB) Program Resource Limit

The property limit for the TB program is $2,000.

Exception:Exception:

When determining a child’s property eligibility and two parents are in the home, allow the parents a $3000 property limit prior to deeming to the child.

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5.11 Aged & Disabled (A&D) FPL Income Disregard

A&D FPL Income Disregard Amount Chart

Individual Couple

$230 $310

5.12 Blind FPL (FPL-B) Income Disregard

Blind FPL (FPL-B) Income Disregard Chart

Blind Individual Blind CoupleOne Individual is Blind

$230 SSI/SSP Payment Rate (Refer to SSI Chart Book)

SSI/SSP Payment Rate (Refer to SSI Chart Book)

5.13 Income In-Kind Values (Effective 7/1/89)

Housing

Table 5-9: Income In-Kind Housing Values

1 individual $153

2 individuals 206

3 individuals 225

4 or more individuals 236

Utilities, including Telephone

Table 5-10: Income In-Kind Utilities Values

1 individual $33

2 individuals 38

3 individuals 40

4 or more individuals 41

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Food

Table 5-11: Income In-Kind Food Values

1 individual $86

2 individuals 182

3 individuals 232

4 individuals 286

5 individuals 346

6 individuals 401

7 individuals 447

8 individuals 490

9 individuals 537

10 or more individuals 582

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5.14 Social Security Charts

5.14.1 Medicare Premiums

Table 5-12: Medicare Premiums Charts

Year Part A* InsuranceSupplemental Medical Insurance — Part B**

1/20 $458.00 $144.60

1/19 $437.00 $135.50

1/18 $422.00 $134.00

1/17 $413.00 $109.00

1/16 $411.00 $104.90

1/15 $407.00 $104.90

1/14 $426.00 $104.90

1/13 $441.00 $104.90

1/12 $451.00 $99.90

1/11 450.00 96.40

1/10 461.00 96.40

1/09 443.00 96.40

1/08 423.00 96.40

1/07 410.00 93.50

1/06 393.00 88.50

1/05 375.00 78.20

1/04 343.00 66.60

1/03 316.00 58.70

1/02 319.00 54.00

1/01 300.00 50.00

1/00 301.00 45.50

1/99 309.00 45.50

1/98 309.00 43.80

1/97 311.00 43.80

1/96 289.00 42.50

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* Part A: The monthly premium amount is paid only by those individuals who are not otherwise eligible and have voluntarily enrolled. Certain individuals may qualify for a reduced premium; or, they may be required to pay a penalty charge due to delayed enrollment.

**Part B: The monthly premium amount can be more.

Note:

Some individuals with fewer than 30 quarters of coverage may buy Medicare Part A for a monthly premium of $458 for 2020. Individuals who have between 30-39 quarters may buy into Part A at a reduced rate of $252 for 2020.

Medicare Part B Premiums

The Medicare Part B Premium is based on an individual’s annual income. ThePart B Premium for beneficiaries who file a Tax Return is below:

Annual Income Individual Tax Return

Annual IncomeJoint Tax Return

File Married and Separate Tax Return

MonthlyPart B Premium

$87,000 or Less $174,000 or Less $87,000 or Less $144.60

$87,000 to $109,000 $174,000 to $218,000 N/A $202.40

$109,000 - $136,000 $218,000 - $272,000 N/A $289.20

$136,000 - $163,000 $272,000 - $326,000 N/A $376.00

$163,000 - $500,000 $326,000 - $750,000 $87,000 - $413,000 $462.70

$500,000 or More $750,000 or More $413,000 or More $491.60

1/95 261.00 46.10

1/94 245.00 41.10

1/93 221.00 36.60

1/92 192.00 31.80

1/91 177.00 29.90

Table 5-12: Medicare Premiums Charts

Year Part A* InsuranceSupplemental Medical Insurance — Part B**

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5.14.2 Medicare Part A and B Deductibles

2020 Deductible/Coinsurance

Part A $1408 deductible for the benefit period

$352 coinsurance per day for days 61 through 90

$704 coinsurance per day beyond the 90th Day of the Benefit Period

$176 for skilled nursing for days 21-100

Note: There is no skilled nursing facility deductible assessed for the first 20 days of residency.

Part B $198

2019 Deductible/Coinsurance

Part A $1364 deductible for the benefit period

$341 coinsurance per day for days 61 through 90

$682 coinsurance per day beyond the 90th Day of the Benefit Period

$170.50 for skilled nursing for days 21 - 100.

Note: There is no skilled nursing facility deductible assessed for the first 20 days of residency.

Part B $185

2017 Deductible/Coinsurance

Part A $1316 deductible for the benefit period

$329 coinsurance per day for days 61 through 90

$658 coinsurance per day beyond the 90th Day of the Benefit Period

$164.5 0 for skilled nursing for days 21 - 100Note: There is no skilled nursing facility deductible assessed for the first 20 days of residency.

Part B $183

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2018 Deductible/Coinsurance

Part A $1340 deductible for the benefit period

$335 coinsurance per day for days 61 through 90

$670 coinsurance per day beyond the 90th Day of the Benefit Period

$164.50 for skilled nursing for days 21 - 100.

Note: There is no skilled nursing facility deductible assessed for the first 20 days of residency.

Part B $183

5.14.3 Medicare Part D

Recipients enrolled in Part D pay a monthly income-related adjustment amount according to their tax return:

Individual Tax Return With Income

Joint Tax Return With Income

File Married and Separate Tax Return

Amount Paid in Addition to Plan Premium

$85,000 or less $170,000 or less $85,000 or less $0.00

$85,000 to $107,000 $170,000 to $214,000 N/A $13

$107,000 to $133,500 $214,000 to $267,000 N/A $33.60

$133,500 to $160,000 $267,000 to $320,000 N/A $54.20

$160,000 or more $320,000 or more $85,000 or more $74.80

5.14.4 Social Security/Medicare Claim

The Medicare CLAIM NUMBER is made up of the individuals ACCOUNT NUMBER (SSN) plus a suffix. This suffix (a letter alone, or a letter plus a number) is called “CLAIMS SYMBOL”. Effective 04/01/2018, the Medicare CLAIM NUMBER will consist of 11 alphanumeric characters excluding letters S, L, O, I, B and Z to replace the individual’s SSN. [Refer to UGSS Update 2018-01 for more details.]

The claims symbols are a code:

• To identify beneficiaries.• To indicate the type of Social Security benefits, if any.• To identify which of 7 different trust funds will pay the Medicare bill or the Social Security benefits.

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Claims Symbols for Retirement Benefits

Table 5-13: Claims Symbols for Retirement Benefits

1st Claimant

2nd Claimant

3rd Claimant

4thClaimant

5thClaimant

Wage Earner A

Wife age 62 or Older

B B3 B8 BA BD

Wife Under Age 62

B2 B5 B7 BK BL

Divorced Wife

B6 B9 BN BP BQ

Note:

Wife under age 62 has an entitled child in her care.

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Claims Symbols for Survivor Benefits

Table 5-14: Claim Symbols for Survivor Benefits

1st Claimant

2nd Claimant

3rd Claimant

4th Claimant

5thClaimant

Child (including Disabled or Student Child)

C “C” numbers are assigned by age of child.C1 Youngest C2 Next older C3 Older than C2 C4 Through C9 CA Tenth child (not C-10) CB 11th child (not C-11)CC 12th child (not C-12), etc.

Widow Age 60 or older

D D2 D8 DD DG

Widow Remarried After Age 60

D4 D9 DA DL DN

Surviving Divorced Wife

D6 D7 DV DW DY

Mother (Widow)

E E2 E7 E8 EA

Surviving Divorced Mother

E1 E3 EB EC ED

Husband age 62 or Older

B1 B4 BG BH BJ

Divorced Husband

BR BT

Widower age 60 or Older

D1 D3 DH DJ DK

Widower Remarried

D5 DP DQ DR DT

Widowed Father

E4 E6 EF EG EH

Surviving Divorced Father

E5 E9 EJ EK EM

Father F1 F7

Mother F2 F8

Stepfather F3

Stepmother F4

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Claims Symbols for Disability Benefits

H — before any claims symbol listed in (C) above under “retirement benefits” tells you the person is receiving disability benefits under Social Security.

Example:

HA Disabled Wage EarnerHC1 Youngest child of disabled Wage Earner (HC2, etc.)HB2 “Young” wife of disabled Wage Earner with child in her care.

Adopting Father

F5

Adopting Mother

F6

Table 5-14: Claim Symbols for Survivor Benefits

1st Claimant

2nd Claimant

3rd Claimant

4th Claimant

5thClaimant

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Claims symbols for individuals, in relation to Health Insurance benefits (Part A, Medicare)Special age 72 Social Security benefits (Prouty Amendment)

1st Claimant

2nd Claimant

3rd Claimant

4th Claimant

5th Claimant

Entitled to HIB (less than 3 QCs) J1

Entitled to HIB (3 QCs or more) J2

Not entitled to HIB (less than 3 QCs) J3

Not entitled to HIB (3 QCs or more) J4

Wife entitled to HIB (less than 3 QCs) K1 K5 K9 KD KH

Wife entitled to HIB (3 QCs or more) K2 K6 KA KE KJ

Wife not entitled to HIB (less than 3 QCs)

K3 K7 KB KF KL

Wife not entitled to HIB (3 Qcs or more)

K4 K8 KC KG KM

Black Lung miner LM

Black Lung miner's widow LW

Claims symbols for Supplementary Medical Insurance Benefits (Part B, Medicare) abbreviated SMIB.

1st Claimant

2nd Claimant

3rd Claimant

4th Claimant

5thClaimant

Uninsured (not entitled to HIB, qualified for SMIB)

M

Uninsured (qualified for HIB, but requested only SMIB

M1

Uninsured (entitled to HIB under deemed insured provision)

T

Disabled widow W W2 W4 W9 WF

Disabled widower W1 W3 W5 WB WG

Disabled surviving divorced wife W6 W7 W8 WC WJ

Table of RRB (Railroad Retirement Board) Prefixes and Equivalent SSA BIC (Beneficiary

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Identification Code).

RRB Claim Prefix Type RRB Beneficiary

A Retirement — employee or annuitant

H RR pensioner (age or disability)

MA Spouse of RR employee or annuitant (husband or wife)

MH Spouse of RR pensioner

WCD 1 Child of RR employee

WCA 1 Child of RR annuitant

CA Disabled adult child of RR annuitant

WD Widow or widower of an RR employee

WA Widow or widower of an RR annuitant

WH Widow or widower of an RR pensioner

WCD 1 Widow of employee with a child in her care

WCA 1 Widow of annuitant with a child in her care

WCH Widow of pensioner with a child in her care

PD Parent of RR employee

PA Parent of RR annuitant

PH Parent of RR pensioner

JA Survivor joint annuitant — an annuitant who has taken a reduced amount of guarantee payments to a surviving spouse

1 WCD and WCA have two designations each.

5.15 Substantial Gainful Activity (SGA) Chart

Table 1: SGA Amounts

Effective Date SGA Amount

1/1/20 $1,260

1/1/19 $1,220

1/1/18 $1,180

1/1/17 $1,170

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1/1/16 $1,130

1/1/15 $1,090

1/1/14 $1,070

1/1/13 $1,040

1/1/12 $1,010

1/1/10 - 12/31/11 $1,000

1/1/09 $980

1/1/08 $940

1/1/07 $900

Table 1: SGA Amounts

Effective Date SGA Amount

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5.16 Pickle Disregard Computation Chart

Last SSI/SSP Check Received Between

Cost of Living Adjustment (COLA)

Multiplier

1/19 through 12/19 1.016 0.0157

1/18 through 12/18 1.028 0.0426

1/17 through 12/17 1.020 0.0613

1/16 through 12/16 1.003 0.0641

1/15 through 12/15 1.000 0.0641

1/14 through 12/14 1.017 0.0798

1/13 through 12/13 1.015 0.0934

1/12 through 12/12 1.017 0.1085

1/11 through 12/11 1.036 0.1395

1/10 through 12/10 1.000 0.1395

1/09 through 12/09 1.000 0.1395

1/08 through 12/08 1.058 0.1867

1/07 through 12/07 1.023 0.2050

1/06 through 12/06 1.033 0.2304

1/05 through 12/05 1.041 0.2607

1/04 through 12/04 1.027 0.2801

1/03 through12/03 1.021 0.2949

1/02 through 12/02 1.014 0.3047

1/01 through 12/01 1.026 0.3223

1/00 through 12/00 1.035 0.3452

1/99 through 12/99 1.024 0.3605

1/98 through 12/98 1.013 0.3688

1/97 through 12/97 1.021 0.3817

1/96 through 12/96 1.029 0.3992

1/95 through 12/95 1.026 0.4144

1/94 through 12/94 1.028 0.4303

1/93 through 12/93 1.026 0.4448

1/92 through 12/92 1.030 0.4609

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Presumed Maximum Value (PMV)

Value of One-Third Reduction (VTR)

Table 5-16: Value of One-Third Reduction

Individual $261.00

Couple $391.66

1/91 through 12/91 1.037 0.4802

1/90 through 12/90 1.054 0.5068

1/89 through 12/89 1.047 0.5289

1/88 through 12/88 1.040 0.5471

1/87 through 12/87 1.042 0.5653

1/86 through 12/86 1.013 0.5709

1/85 through 12/85 1.031 0.5838

1/84 through 12/84 1.035 0.5979

7/82 through 12/83 1.035 0.6115

7/81 through 6/82 1.074 0.6382

7/80 through 6/81 1.112 0.6747

7/79 through 6/80 1.143 0.7154

7/78 through 6/79 1.099 0.7410

7/77 through 6/78 1.065 0.7568

4/77 through 6/77 1.059 0.7704

Table 5-15: Presumed Maximum Value

Individual $281.00

Couple $411.66

Last SSI/SSP Check Received Between

Cost of Living Adjustment (COLA)

Multiplier

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5.17 Sneede Maintenance Need Income Levels (MNIL) and Property Limits

Table 5-17: Sneede Maintenance Need Income Levels and Property Limits

Sneede v KizerMaintenance Need Income Levels (MNIL) and Property Limits Effective: 1/1/90

MNIL and Property Limits

MNIL/Property Limits for Adults - No Children in Mini Budget Unit

Person Type MNIL Property

Single Parent 600 2,000

Single Parent with Unborn 750 3,000

Married Couple (two adults) 934 3,000

Married Couple with an unborn 934 3,150

Unmarried Couple-for each unmarried partner 600 2,000

MNIL/Property Limit for Mini Budget Unit (MBU) Which Contains Parent(s) and Child(ren)- May include an unborn.

Allow the full standard/non-Sneede MNIL/property limits for the MBU based upon the number of individuals in the MBU.

MNIL/Property Limit for Caretaker Relative Household

Caretaker relative in same MFBU with children for whom care is provided. Each MBU receives full standard, non-Sneede MNIL/property limit based on the number of individuals in each MBU. If there is a pregnant minor in MFBU, include unborn in pregnant minor's MBU.

MNIL/Property Limit for Mini Budget Unit Which Contains Only Child(ren) Living With Natural/Adoptive Parent(s). Do not include parents who are not in the MFBU. May include unborn of pregnant minor if unborn is the same MFBU.

No. of Children in MBU

One Parent Two Parents

MNIL Property MNIL Property

1 375 1,500 312 1,050

2 623 2,100 550 1,650

3 825 2,475 756 2,070

4 1,008 2,760 945 2,400

5 1,181 3,000 1,108 2,679

6 1,329 3,215 1,269 2,925

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7 1,481 3,413 1,420 3,150

8 1,623 3,600 1,568 3,360

9 1,764 3,780 1,615 3,436

10 1,794 3,818 1,656 3,500

11 1,822 3,850 1,694 3,554

12 1,848 3,877 1,728 3,600

13 1,872 3,900 1,759 3,640

Table 5-17: Sneede Maintenance Need Income Levels and Property Limits

Sneede v KizerMaintenance Need Income Levels (MNIL) and Property Limits Effective: 1/1/90

MNIL and Property Limits

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