Medical - Kansas Economic and Employment Services Manual

7240 Income deductions - The following deductions are used in the medical assistance programs to determine countable income.

7241 Deductions for MS, QMB, LMB, QWD, and Working Healthy - A portion of all income (earned or unearned) is disregarded from gross nonexempt income in determining eligibility. Except for IRWE and BWE disregards described below, one disregard is allowed for the combined incomes of all individuals in the plan and any legally responsible persons who are in the home and excluded from the plan. For IRWE and BWE, separate deductions apply for each participating member of the assistance plan. Disregarded income is not considered available to meet medical expenses. For deductions related to NF, see 8151. For deductions related to HCBS, see 8250.

The following are the amounts to be disregarded:

1. From earned income, certain work expense deductions. This disregard does not apply to ineligible members of the assistance plan. The amount of the disregard cannot exceed the amount of earned income for each individual. The standard amounts may be deducted if allowable expenses are reported. If expenses exceed this amount, actual expenses may be used but must be verified and averaged. Expenses cannot be subject to reimbursement from any source (including Medicaid, WORK payments, or the employer).
    

   1. Blind Work Expense (BWE) - For the blind, the first $300 of earned income is disregarded for persons reporting allowable work expense(s). If verified expenses exceed this amount, actual average expenses shall be allowed. Allowable expenses for the blind are expenses reasonably attributable to earnings of the income. The following are allowable expenses:
       

      • Guide dog expenses including the (cost of obtaining and maintaining the animal such as food, licenses and vet bills);
         

      • Transportation to and from work (For purposes of determining actual expenses for private transportation, the current state reimbursement rate for privately owned vehicles shall be used. This includes the increased rate for specially equipped or modified vehicles to accommodate a disability. Because this standard mileage rate includes expenses for gas, oil, insurance, etc. in the determination, these items are not separately allowable. The cost of modifying a vehicle are allowable (e.g., installing a ramp) but the cost of the actual vehicle is not. Actual costs of public transportation (e.g., cab fare, bus tokens) shall be allowed.);
         

      • Federal, state and local income taxes, Social Security tax;
         

      • Attendant care services;
         

      • Visual aides and translation services;
         

      • Drugs (except for lifestyle or cosmetic medications) and other medical expenses or equipment NOT covered by Medicaid, Medicare or other insurance, including co-payments;
         

      • Costs of training to use special equipment.

2. Impairment Related Work Expense (IRWE) - For others, the first $100 of earned income is disregarded for persons reporting allowable work expense(s). If verified expenses exceed this amount, actual average expenses shall be allowed. Allowable expenses are those directly related to enabling a person to work which are incurred because of a physical or mental impairment. The following are allowable expenses:

   • Attendant care performed in the work setting or helping prepare for work;
      

   • Specialized Transportation to and from work; Examples include structurally modified vehicles to accommodate the individuals disability (both the operating costs and the cost to modify), the costs of a driver or taxi cab if the individual requires assistance and cannot manage to get off or on public transportation or public transportation has not been modified for the person’s disability (e.g., wheelchair accessible). Transportation is not allowable for persons who can drive an unmodified car or utilize public transportation without assistance.
      

     For purposes of determining actual expenses for private transportation, the current state reimbursement rate for privately owned specially equipped vehicles shall be used. This is the increased rate for specially equipped or modified vehicles to accommodate a disability. Because this standard mileage rate includes expenses for gas, oil, insurance, etc. in the determination, these items are not separately allowable. Actual costs of public transportation (e.g., cab fare, bus tokens) shall be allowed. The cost of modifying a vehicle are allowable (e.g., installing hand controls) but the cost of the actual vehicle is not.
      

   • Drugs (except for lifestyle or cosmetic medications) and other medical expenses or equipment NOT covered by Medicaid or other insurance, including co-payments;
      

   • Service Animal expenses including the costs of obtaining and maintaining the animal such as food, licenses and vet bills;
      

   • Non-medical equipment and services, such as tools and one-handed typewriters, related to the impairment.

2. The first $20 per month of any income (this disregard is to be applied first to unearned income, if any, with any remainder of the disregard applied to earned income, if any); and
    

3. The first $65 per month of gross (or adjusted gross) earned income; and
    

4. One-half of the remainder of earned income.
   
   

7242 Deductions for MediKan - There are no income deductions for the MediKan program. The gross monthly countable income is budgeted against the income limit for the appropriate household size (7430 (5)).