County of San Diego Health and Human Services Agency HHSA MediCal Program Guide Special Notice 2022 Medicare Catastrophic Coverage Act Spousal Impoverishment
Number
Page Caps and Substantial Gainful Activity SGA
2201
1of 1
Effective Date
01012022
Background
The Substantial Gainful Activity SGA amount is used to determine if an individual who is claiming a disability and is also working has linkage to NonModified Adjusted Gross Income MAGI MediCal based on their disability The Community Spouse Resource Allowance CSRA is the amount of countable property the community spouse is allowed to retain when the institutionalized spouse applies for MediCal benefits The amounts for the Substantial Gainful Activity SGA Community Spouse Resource Allowance CSRA and Minimum Monthly Maintenance Needs Allowance MMMNA are updated annually
Purpose
To provide staff with the updated SGA CSRA and MMMNA amounts
Policy
Effective January 1 2022 the SGA CSRA and MMMNA amounts are as follows
SGA NonBlind Individuals 1350
Blind Individuals 2260 CSRA
137400 MMMNA
3435
Procedure
Use the updated CSRA and MMMNA when determining spousal impoverishment for an institutionalized individual Use the updated SGA amount when completing an SGA determination as outlined on MediCal Program Guide MPG 050403
Automation Impact
Staff must use BEnDS 49130 Spousal Impoverishment Provisions until the CSRA and MMMNA values have been updated in CalWIN when determining spousal impoverishment
References
ACWDLs 2121E 2134
Sunset Date
This policy will be reviewed for continuance on or by 01312023
Approval for Release
Rick Wanne Director SelfSufficiency Services