A Calculation for the Customer Only Examples

Programs	Manual Section
SSI MAO	MA611

Examples

1) Eligible under the 100% FBR Standard

The customer, a 65-year-old single individual, resides with her two adopted children ages 10 and 12. The customer applies for AHCCCS Medical Assistance for herself in January 2025.

The customer receives $1,100.00 for Social Security Retirement per month. She also works part-time to make extra money and received $780.00 in January 2025. The two children do not have any income.

Calculate the customer’s eligibility as follows:

Step	Action
1	Calculate net unearned income: $1,100.00 (customer’s total countable unearned income that is not needs based) -$0.00 1/3 child support deduction (not applicable) =$1,100.00 (subtotal) -$20.00 (general income deduction) =$1,080.00 (subtotal) +$0.00 income based on need (not applicable) =$1,080.00 (net unearned income)
2	Calculate net earned income: $780.00 customer’s total countable earned income -$0.00 (unused portion of the $20.00 general income deduction) -$65.00 (standard work expense deduction) -$0.00 (IRWE deduction) =$715.00 (subtotal of earned income) -$357.50 (one-half of the subtotal of earned income) -$0.00 (blind work expense deduction) =$357.50 (net earned income)
3	Calculate total net income: $1,080.00 (net unearned income from Step 1 above) +$357.50 (net earned income from Step 2 above) =$1,437.50 (subtotal of net income) -$966.00 child allocation ($483.00 per child, two children) =$471.50 (total net income)
4	Compare the result in Step 3 above to $967.00 (100% of the FBR for an individual for 2025). Because $471.50 is less than $967.00, the customer is income eligible for AHCCCS Medical Assistance under SSI-MAO using the 100% FBR standard.

2) Eligible under the 100% FPL Standard

The customer is a 70-year-old single individual. The customer applies for AHCCCS Medical Assistance in February 2025.

The customer receives monthly income of $1,050.00 Social Security retirement. He also works part time and made $125.00 in February 2025 from his job.

The customer’s eligibility is calculated as follows:

Step	Action
1	Calculate net unearned income as follows: $1,050.00 customer’s total countable unearned income that is not needs based -$0.00 1/3 child support deduction (not applicable) =$1,050.00 subtotal -$20.00 (general income deduction) =$1,030.00 subtotal +$0.00 income based on need (not applicable) =$1,030.00 net unearned income
2	Calculate net earned income as follows: $125.00 (customer’s total countable earned income) -$0.00 (unused portion of the $20.00 general income deduction) -$65.00 (standard work expense deduction) -$0.00 (IRWE deduction) =$60.00 (subtotal of earned income) -$30.00 (one-half of the subtotal of earned income) -$0.00 (blind work expense deduction) =$30.00 (net earned income)
3	Calculate total net income as follows: $1,030.00 (net unearned income from Step 1 above) +$30.00 (net earned income from Step 2 above) =$1,060.00 subtotal of net income -$ 0.00 child allocation (not applicable) =$1,060.00 (total net income)
4	Compare the result in Step 3 above to $967.00 (100% of the FBR for an individual). Because $1,060.00 is greater than $967.00, the customer is income ineligible for AHCCCS Medical Assistance using the FBR standard. Continue to Step 5 to determine eligibility using the 100% FPL standard.
5	Take the total net income result from Step 3 and add the one-half subtotal of earned income from Step 2 back in: $1,060.00 (total net income from FBR test) +$30.00 (one-half subtotal of earned income) =$1,090.00 (total net income)
6	Compare the result in Step 5 above to $1,305.00 (100% of the FPL for an individual): Because $1,090.00 is less than $1,305.00, the customer is income eligible for SSI-MAO using the FPL standard.