Body
Revision 22-3; Effective September 1, 2022
Eligibility income budgeting for Medicaid Buy-In for Children (MBIC) is different from other MEPD programs.
The family gross income (earned and unearned) must not exceed 300% of the FPL.
Due to substantial income exclusions, the income limit used for the eligibility determination is equal to or less than 150% FPL for the family size. The income limit for each case may be different depending on the family size.
Related Policy
Budget Reference Chart, Appendix XXXI
N-6310 Income Treatment
Revision 11-3; Effective September 1, 2011
Treat earned and unearned income the same in MBIC budgeting. Do not deduct:
- the $20-general exclusion, or
- the earned income exclusion of $65 plus one-half of the remaining income.
N-6320 MBIC Income Exclusion
Revision 11-3; Effective September 1, 2011
The MBIC income exclusion is $85 plus one-half of the remaining income and is deducted at the end of the budget calculation.
N-6330 Ineligible Sibling Exclusion
Revision 26-2; Effective June 1, 2026
Allow an exclusion from an ineligible sibling's income before counting the ineligible sibling's income in the eligibility budget. Allow this exclusion for each ineligible sibling in the family unit. The base exclusion amount changes each year and is equal to two times 150% FPL for a family of one plus $85.
Effective March 1, 2026, the ineligible sibling's exclusion amount is $4,075. Deduct this amount from the ineligible sibling's total income and count any remaining income in the budget. If the ineligible sibling's income is less than the total exclusion, disregard all the ineligible sibling's income in the budget.
Related Policy
Examples of Budgeting Steps, N-6351
N-6340 Determining the Budget Group
Revision 15-4; Effective December 1, 2015
The budget group is determined by identifying the members of the family unit whose income is countable in the eligibility budget. The number of people in the family unit and in the budget group may be different.
Do not count any of the income of a family unit member that:
- has needs-based income, such as veteran's pension or Supplemental Security Income (SSI); or
- is a Medicaid-eligible person, such as another MBIC applicant/recipient in the household.
For a stepparent's income to count, the stepparent must:
- be the current spouse of a natural or adoptive parent, and
- live in the same household as the MBIC applicant or recipient and the natural or adoptive parent.
If a stepparent's income is not considered because these criteria are not met, do not consider a stepsibling's income either.
Reminders:
- If school or job training attendance has not been verified for an ineligible sibling between ages 18 and 22, that sibling is not part of the family unit and, therefore, is not included in the budget group.
- Consider absences due to active military assignments as temporary and include that individual in the budget group.
N-6350 Budgeting Steps
Revision 22-3; Effective September 1, 2022
Income related budget steps:
- Determine the family unit members.
- Determine the appropriate FPL based on the family size. The FPL that corresponds to the total number of family unit members is the income limit for the family. Example: For a family unit of five, the income limit is 150% of the FPL for a family of five.
- Determine the budget group members.
- Determine the monthly gross countable earned and unearned income, if any, of the MBIC applicant or recipient.
- Determine the combined monthly gross countable earned and unearned income of the applicant or recipient's parents.
- For each ineligible sibling, determine any monthly gross countable income that exceeds the ineligible sibling's exclusion amount. If the exclusion amount is greater than the ineligible sibling's income, disregard all of that ineligible sibling's income.
- Total the income amounts determined in steps 4-6.
- Subtract $85 from the total in step 7.
- Divide the amount in step 8 by two.
The remainder is countable income. Compare this to the income limit determined in step 2.
Related Policy
Budget Reference Chart, Appendix XXXI
N-6351 Examples of Budgeting Steps
Revision 26-2; Effective June 1, 2026
The figures used in these charts are examples only. They may not reflect the current federal poverty level (FPL) limits or the deduction amounts that are based on FPL.
Example 1
The members of the household are:
- Applicant — no income
- Applicant's parent — gross earnings $2,400 monthly
- Applicant's stepparent — gross earnings $3,000 monthly
- Applicant's ineligible 16-year-old sibling — no income
- Applicant's ineligible 19-year-old sibling, non-student — gross earnings $800 monthly
- Applicant's ineligible 14-year-old stepsibling — no income
Note: Since the 19-year-old ineligible sibling is over 18 and not a student, do not consider the sibling or the sibling's income.
- Determine the family unit members.
- Applicant
- Applicant’s parent
- Applicant’s stepparent
- Applicant’s ineligible 16-year-old sibling
- Applicant’s ineligible 14-year-old stepsibling
Determine the appropriate FPL based on the family size.
Income limit: 150% FPL for family of five = $4,835
Determine the budget group members.
Budget group is the same as the family unit.
Determine the monthly gross countable earned and unearned income, if any, of the MBIC applicant or recipient.
Applicant’s monthly gross countable income = $0
Determine the combined monthly gross countable earned and unearned income of the applicant or recipient's parents.
Parents' monthly gross countable income = $5,400
For each ineligible sibling, determine any monthly gross countable income that exceeds the ineligible sibling's exclusion amount.
Income of each ineligible sibling that exceeds $4,075 = $0
Total the income amounts determined in steps 4–6.
$0 applicant’s monthly gross countable income + $5,400 parents’ monthly gross countable income + $0 ineligible siblings’ gross countable income = $5,400 total budget group income
Subtract $85 from the total in step 7 to begin applying the MBIC income exclusion.
$5,400 – $85 = $5,315
Divide the amount in step 8 by two to complete the MBIC income exclusion. Compare to the income limit determined in step 2.
$5,315/2 = $2,657.50 ≤ $4,835
Eligibility result: Eligible
Example 2
The members of the household are:
- Applicant — Retirement, Survivors, and Disability Insurance (RSDI) $167
- Applicant's parent — gross earnings $4,500 monthly
- Applicant's ineligible 16-year-old sibling — gross earnings $100 monthly
- Applicant's 20-year-old ineligible sibling, student — gross earnings $400 monthly
- Applicant's 10-year-old stepsibling — no income
Stepparent died one year ago.
Note: Since the stepparent is deceased, do not consider the ineligible stepsibling or the ineligible stepsibling's income.
- Determine the family unit members.
- Applicant
- Applicant’s parent
- Applicant’s ineligible 16-year-old sibling
- Applicant’s ineligible 20-year-old sibling (student)
Determine the appropriate FPL based on the family size.
Income limit: 150% FPL for family of four = $4,125
Determine the budget group members.
Budget group is the same as the family unit.
Determine the monthly gross countable earned and unearned income, if any, of the MBIC applicant or recipient.
Applicant’s monthly gross countable income = $167
Determine the combined monthly gross countable earned and unearned income of the applicant or recipient's parents.
Parent’s monthly gross countable income = $4,500
For each ineligible sibling, determine any monthly gross countable income that exceeds the ineligible sibling's exclusion amount.
Income of each ineligible sibling that exceeds $4,075= $0
Total the income amounts determined in steps 4–6.
$167 applicant’s monthly gross countable income + $4,500 parent’s monthly gross countable income + $0 ineligible siblings’ gross countable income = $4,667 total budget group income
Subtract $85 from the total in step 7 to begin applying the MBIC income exclusion.
$4,667 – $85 = $4,582
Divide the amount in step 8 by two to complete the MBIC income exclusion. Compare to the income limit determined in step 2.
$4,582/2 = $2,291 ≤ $4,125
Eligibility result: Eligible
Example 3
The members of the household are:
- Applicant — RSDI $88
- Applicant's stepparent — gross earnings $5,925 monthly
- Applicant's ineligible 2-year-old sibling — no income
- Applicant's ineligible 19-year-old sibling, non-student — gross earnings $800 monthly
- Applicant's ineligible 7-year-old stepsibling — no income
Applicant’s parent died two years ago.
Note: Do not consider the stepparent and the ineligible stepsibling or their income since the natural parent died and the stepparent is not a current spouse of the natural parent. Do not consider the sibling or the sibling's income since the 19-year-old ineligible sibling is over 18 and not a student.
- Determine the family unit members.
- Applicant
- Applicant’s ineligible 2-year-old sibling
Determine the appropriate FPL based on the family size.
Income limit: 150% FPL for family of two = $2,705
Determine the budget group members.
Budget group is the same as the family unit.
Determine the monthly gross countable earned and unearned income, if any, of the MBIC applicant or recipient.
Applicant’s monthly gross countable income = $88
Determine the combined monthly gross countable earned and unearned income of the applicant or recipient's parents.
Parents' monthly gross countable income = $0
For each ineligible sibling, determine any monthly gross countable income that exceeds the ineligible sibling's exclusion amount.
Income of each ineligible sibling that exceeds $4,075= $0
Total the income amounts determined in steps 4–6.
$88 applicant’s monthly gross countable income + $0 parent’s monthly gross countable income + $0 ineligible siblings’ gross countable income = $88 total budget group income
Subtract $85 from the total in step 7 to begin applying the MBIC income exclusion.
$88 – $85 = $3
Divide the amount in step 8 by two to complete the MBIC income exclusion. Compare to the income limit determined in step 2.
$3/2 = $1.50 ≤ $2,705
Eligibility result: Eligible
Example 4
The members of the household are:
- Applicant — RSDI $88
- Sibling, 7-year-old, also an applicant — RSDI $88
- Applicant's parent — gross earnings $8,700 monthly
- Applicant's ineligible 2-year-old sibling — no income
Applicant's other parent died two years ago.
Note: Count a sibling in the family unit size if the sibling is also applying for MBIC. Calculate separate budgets since one eligible sibling's income is not counted in the other eligible sibling's budget group.
- Determine the family unit members.
- Applicant
- Applicant's 7-year-old sibling, who is also an MBIC applicant
- Applicant's parent
- Applicant's ineligible 2-year-old sibling
Determine the appropriate FPL based on the family size.
Income limit: 150% FPL for family of four = $4,125
- Determine the budget group members.
- Applicant
- Applicant’s parent
- Applicant's ineligible 2-year-old sibling
Determine the monthly gross countable earned and unearned income, if any, of the MBIC applicant or recipient.
Applicant One’s monthly gross countable income = $88
Applicant Two’s monthly gross countable income = $88
Determine the combined monthly gross countable earned and unearned income of the applicant or recipient's parents.
Parent’s monthly gross countable income = $8,700
For each ineligible sibling, determine any monthly gross countable income that exceeds the ineligible sibling's exclusion amount.
Income of each ineligible sibling that exceeds $4,075 = $0
Total the income amounts determined in steps 4–6.
$88 applicant one’s monthly gross countable income + $8,700 parent’s monthly gross countable income + $0 ineligible siblings’ gross countable income = $8,788- total budget group income for applicant one
$88 applicant two’s monthly gross countable income + $8,700 parent’s monthly gross countable income + $0 ineligible siblings’ gross countable income = $8,788 total budget group income for applicant two
Subtract $85 from the total in step 7 to begin applying the MBIC income exclusion.
Applicant one: $8,788 – $85 = $8,703
Applicant two: $8,788 – $85 = $8,703
Divide the amount in step 8 by two to complete the MBIC income exclusion. Compare to the income limit determined in step 2.
Applicant one: $8,703/2 = $4,351.50 ≥ $4,125
Applicant two: $8,703/2 = $4,351.59 ≥ $4,125
Eligibility result for applicant one: Not eligible
Eligibility result for applicant two: Not eligible
Example 5
The members of the household are:
- Applicant — RSDI $88
- Applicant's parent — RSDI $699
- Applicant's ineligible 2-year-old sibling — RSDI $88
- Applicant's ineligible 5-year-old sibling — RSDI $88
- Determine the family unit members.
- Applicant
- Applicant’s parent
- Applicant's ineligible 2-year-old sibling
- Applicant's ineligible 5-year-old sibling
Determine the appropriate FPL based on the family size.
Income limit: 150% FPL for family of four = $4,125
Determine the budget group members.
Budget group is the same as the family unit.
Determine the monthly gross countable earned and unearned income, if any, of the MBIC applicant or recipient.
Applicant’s monthly gross countable income = $88
Determine the combined monthly gross countable earned and unearned income of the applicant or recipient's parents.
Parent’s monthly gross countable income = $699
For each ineligible sibling, determine any monthly gross countable income that exceeds the ineligible sibling's exclusion amount.
Income of each ineligible sibling that exceeds $4,075 = $0
Total the income amounts determined in steps 4–6.
$88 applicant’s monthly gross countable income + $699 parent’s monthly gross countable income + $0 ineligible siblings’ gross countable income = $787 total budget group income
Subtract $85 from the total in step 7 to begin applying the MBIC income exclusion.
$787 – $85 = $702
Divide the amount in step 8 by two to complete the MBIC income exclusion. Compare to the income limit determined in step 2.
$702/2 = $351 ≤ $4,125
Eligibility result: Eligible
Example 6
The members of the household are:
- Applicant — no income
- Applicant's parent — gross earnings $4,500 monthly
- Applicant's other parent — $850 Veterans Affairs (VA) benefits with aid and attendance monthly; gross earnings of $300 monthly
- Determine the family unit members.
- Applicant
- Applicant’s parents
Determine the appropriate FPL based on the family size.
Income limit: 150% FPL for family of three = $3,415
Determine the budget group members.
Budget group is the same as the family unit.
Determine the monthly gross countable earned and unearned income, if any, of the MBIC applicant or recipient.
Applicant’s monthly gross countable income = $0
Determine the combined monthly gross countable earned and unearned income of the applicant or recipient's parents.
Parents' monthly gross countable income = $4,500
VA income is needs-based, so none of the other parent's income is included in the budget.
Determine any monthly gross countable income that exceeds the ineligible sibling's exclusion amount for each ineligible sibling.
Step does not apply because applicant has no ineligible siblings.
Total the income amounts determined in steps 4–6.
$0 applicant’s monthly gross countable income + $4,500 parents’ monthly gross countable income = $4,500 total budget group income
Subtract $85 from the total in step 7 to begin applying the MBIC income exclusion.
$4,500 – $85 = $4,415
Divide the amount in step 8 by two to complete the MBIC income exclusion. Compare to the income limit determined in step 2.
$4,415/2 = $2,207.50 ≤ $3,415
Eligibility result: Eligible