Fillable Printable Income Desk Aid
Fillable Printable Income Desk Aid
Income Desk Aid
ELIGIBILITY STANDARDS DESK AID
Effective 10/01/2017
ALTCS
FEDERAL BENEFIT RATES (FBR)
Eff. 1/1/15 to
12/31/15
Eff. 1/1/16 to
12/31/16
Eff. 1/1/17 to
12/31/17
1.Individual FBR/Single paren t all ocation
$733.00
$733.00
$735.00
2.Couple FBR/2 parent allocation
$1,100.00
$1,100.00
$1,103.00
3.Institutional FBR
$30.00
$30.00
$30.00
4.300% Individual FBR
$2,199.00
$2,199.00
$2,205.00
5.Child Allocation
$367.00
$367.00
$368.00
6.15% of Individual FBR
$109.95
$109.95
$110.25
MEDICARE P ART B PRE MI UMS
Eff.1/1/15 – 12/31/15
Eff. 1/1/16 - 12/31/16
Eff. 1/1/17 - 12/31/17
$104.90
$121.80
$134.00
MEDICARE P ART D EXTRA HE LP SUBSIDY AMOUNT FOR ARIZONA
Eff. 1/1/15 – 12/31/15
Eff. 1/1/16 – 12/31/16
Eff. 1/1/17 – 12/31/17
$32.89
$33.17
$35.11
COMMUNITY SPOUSE STANDARDS
Eff. 1/1/15 to 12/31/15
Eff. 1/1/16 to 12/31/16
Eff. 1/1/17 to 12/31/17
Minimum CSRD
$23,844.00
$23,844.00
$24,180.00
Maximum CSRD
$119,220.00
$119,220.00
$120,900.00
Maximum MMMNA
$2,981.00
$2,981.00
$3,022.50
Eff. 10/1/15
Eff. 10/1/16
Eff. 10/1/17
Standard Utility Allowance
$271.00
$265.00
$274.00
Eff. 7/1/15 to 6/30/16
Eff. 7/1/16 to 6/30/17
Eff. 7/1/17 to 6/30/18
Monthly Spousal Need (MSN)
$1,992.00
$2,003.00
$2,030.00
30% of the Monthly Spousal Need for
Excess Shelter Allowance
$598.00
$601.00
$609.00
Maximum Fam ily Allowance for a
Dependent With No Income
$664.00
$668.00
$677.00
AVERAGE PRIVATE PAY RATES
HOME MAINTENANCE ALLOWANCE
Location
10/1/15
10/1/16
10/1/17
Eff. 1/1/89 to 6/30/ 93
Eff. 7/1/93 to Present
Maricopa, Pima, Pinal
$6,726.48
$6,905.11
$7,134.44
$138.00
$210.00
Balance of State
$5,575.29
$5,667.81
$6,307.74
SSI MAO/MSP
Actual income may be higher than the followin g income standards because there is a $20 sta ndard deduction and other
deductions for earned income and child al locations.
SSI-MAO NON-CASH AND QMB INCOME STANDARDS
SLMB INCO ME STANDARDS
Eff. 2/1/15
Eff. 2/1/16
Eff. 2/1/17
Eff. 2/1/15
Eff. 2/1/16
Eff. 2/1/17
No. Of
People in
Household
100% of FPL:
Monthly
100% of FPL:
Monthly
100% of FPL:
Monthly
Greater than
100%, Less than
or equal to 120%
of FPL: Monthly
Greater than
100%, Less than
or equal to 120%
of FPL: Monthly
Greater than
100%, Less than
or equal to 120%
of FPL: Monthly
1
$981.00
$990.00
$1,005.00
$981.01 -
$1,177.00
$990.01 -
$1,188.00
$1,005.01 -
$1,206.00
2
$1,328.00
$1,335.00
$1,354.00
$1,328.01 -
$1,593.00
$1,335.01 -
$1,602.00
$1,354.01 -
$1,624.00
QUALIFIED INDIVIDUAL STANDARDS
Qualified Individual – 1 (QI-1)
No. Of
People in
Household
Eff. 2/1/15
Eff. 2/1/16
Eff. 2/1/17
Greater than 120%, Less than or
equal to 135% of F PL: Monthly
Greater than 120%, Less than or
equal to 135% of F PL: Monthly
Greater than 120%, Less than or
equal to 135% of F PL: Monthly
1
$1,177.01 - $1,325.00
$1,188.01 - $1,337.00
$1,206.01 - $1,357.00
2
$1,593.01 - $1,793.00
$1,602.01 - $1,803.00
$1,624.01 - $1,827.00
