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Maximum Income, Resource, and Payment Standards

The Oklahoma Health Care Authority's Online Enrollment system determines eligibility for the groups below. Go to www.okhca.org for eligibility information for these groups:

• Children under 19 years of age;
• Parents with minor children;
• Pregnant women;
• Individuals wanting family planning services; and
• Women needing treatment of breast or cervical cancer.

The Oklahoma Department of Human Services (DHS) determines eligibility based on income and resource guidelines displayed in this appendix for persons applying for or receiving:

Schedule I - Categorically Needy Standards for TANF Continued Medical Benefits

Monthly countable income must be equal to or less than the following income standards, which are 185% of Federal Poverty Guidelines. Resources are excluded in determining eligibility. Refer to Oklahoma Administrative Code (OAC) 340:10-3-75.

Schedule II - Revoked

Schedule III - Reserve for Future Use

Schedule IV - Reserve for Future Use

Schedule V - Qualified Disabled and Working Individuals (QDWI)

Monthly countable income and resources must be equal to or less than the following income and resource standards (200% of Federal Poverty Guidelines and double Supplemental Security Income (SSI) resource standards). Refer to OAC 317:35-7-41.

Schedule VI - Categorically Needy Standards for Qualified Medicare Beneficiary Plus (QMBP)

Monthly countable income and resources must be equal to or less than the following income and resource standards (100% of Federal Poverty Guidelines and full benefit Medicare Part D low income subsidy resource standards).Refer to OAC 317:35-7-40.

Schedule VII - Specified Low Income Medicare Beneficiaries (SLMB)

Monthly countable income and resources must be equal to or less than the following income and resource standards (120% of Federal Poverty Guidelines and full benefit Medicare Part D low income subsidy resource standards). Refer to standards). Refer to OAC 317:35-7-43.

Schedule VII.A - Qualifying Individuals - Group One (QI-1s)

Schedule VIII - Aged, Blind, or Disabled Individuals

(B) Approved for care and living in a nursing facility or Intermediate Care Facility for the Intellectually Disabled (ICF/ID). Also includes individuals who receive services through the ADvantage Waiver or other Home and Community Based Waiver, patients 65 years of age or older in a mental hospital, and children eligible for services through the Tax Equity and Financial Responsibility Act (TEFRA).Refer to OAC 317:35-5-49, 317:35-9-68, 317:35-17-9, 317:35-19-20.
The average daily cost of nursing home care is $145.39
        1. Monthly countable income must be equal to or less than the Categorically Needy Standard of $2,205 (300% of Federal Benefit Rate). Maximum monthly countable income for a Medicaid Income Pensions Trust cannot exceed $4,422.
        2. Monthly maintenance standards are the amount of money the client may retain for his or her own needs. (C) Deeming income to blind or disabled minor children. Monthly countable income must be less than the following Federal Benefit Rates.

Schedule IX - TANF - Emergency Assistance (EA)

Monthly countable income must be less than the following standards. EA monthly payment standards are 50% of the TANF payment standard. NOTE: Standards for Refugee Medical Assistance are found on Schedule XIV of this appendix. Refer to OAC 340:10-3-33, 340:10-19-3.

A. Adult only or adults and children included in the assistance payment.
 
B. Children only (no adults) included in the assistance payment.

C. Maximum Reserve: The countable reserve must be equal to or less than $1,000 per TANF case. Non-liquid resources, excluding the home and $5,000 equity in one automobile, cannot exceed $1,000. For EA cases, liquid resources available for immediate use cannot exceed the amount needed to meet the emergency.

Schedule X - Revoked

Schedule XI - Income and resource standards for the community spouse

Income and resource standards for the community spouse when his/her spouse is in a nursing facility or is receiving services through the ADvantage Waiver or other Home and Community Based Waiver.
 

Schedule XII- TANF- Deprivation Based on Unemployment of Parent.

The gross income must be at least the following amounts.          
        A. Base period wage standards for unemployment insurance benefits.

        
       B. Social Security minimum earnings for quarter coverage.
 

Schedule XIII - Tuberculosis (TB) Infected Individuals.

Monthly countable income and resources must be equal to or less than the following income (2 x Federal Benefit Rate + $85) and resource standard.

	Maximum income standard	Maximum resource standard
Individual only	$1,555	$2,000

Schedule XIV - Refugee Medical Assistance

Monthly countable income must be less than the following standards. Monthly countable income is defined as the gross unearned income added to the earned income less income exemptions. Earned income exemptions include $90 work related expenses, $30 and 1/3 of the balance. Rules are based on AFDC policy in effect on July 1, 1996.Refer to OAC 340:60-1-6.
    A. Child(ren) and one or two adults included in the assistance payment. If there is more than one person in a refugee case,
         use the AFDC Standard for appropriate number of persons.
      
    B. Children only (no adults) included in the assistance payment.
      C. Maximum reserve: The countable reserve must be equal to or less than $1,000 per refugee case. Non-liquid resources,
         excluding the home and $5,000 equity in one automobile, cannot exceed $1,000.

Schedule XIV.A - Refugee Cash Assistance

Monthly countable income must be less than the following payment standard per household size. Refer to OAC 340:60-1-6 for eligibility requirements.
    A. The assistance unit may consist of a single adult or an adult, his or her spouse, and all minor children 17 years of age or younger for
         whom the family assumes financial responsibility.
        B. Maximum reserve: The countable reserve must be equal to or less than $1,000 per refugee case. Non-liquid resources,
         excluding the home and $5,000 equity in one automobile, cannot exceed $1,000.
      C. Incentive bonuses: The refugee may receive an early job acceptance bonus of $750 and a job retention bonus of up to $100 per person
           in the assistance unit when he or she meets eligibility criteria per OAC 340:60-1-6.

Schedule XV - Title IV-E eligibility for children in custody of DHS or a federally recognized Indian tribe

Monthly countable income must be less than the NEED standard for size of the household from which the child(ren) was removed. Monthly countable income is defined as the gross unearned income added to the earned income less income exemptions. Earned income exemptions include $90 work related expenses, $30 and 1/3 of the balance. Rules are based on AFDC policy in effect on July 1, 1996.
A. Child(ren) and one or two adults included in the assistance payment.


B. Children only (no adults) included in the assistance payment.


C. Maximum reserve: The countable reserve must be equal to or less than $10,000 per child.

Schedule XVI - TANF Diversion Assistance (DA)

Funds are not currently available for this program.

Schedule XVII - TANF- Supported Permanency

Children only, no adults included in the Supported Permanency Program payment. Refer to OAC 340:10-22-1 and 340:75-6-31.4. The child must be 12 years of age or older or have a sibling 12 years of age or older who resides in the same relative foster home; provided, however, the Child Welfare Services director may, for good cause, approve a child younger or a sibling of an eligible child.
 

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