Income Eligibility Standards

The Administrator shall set standards for determining monthly income for purposes of eligibility, which shall consider the individual’s average pattern of income and earnings, subject to subsequent adjustment if actual experience deviates substantially from the amount determined by such method.

(a)Income Limitations. The Guam MIP Income Guidelines shall be used to determine income eligibility for the Medically Indigent Program. In the calculation of income, payments for medical insurance or Medicare premiums shall be excluded. Prior to the promulgation of the Guam MIP Income Guidelines, Federal Poverty Guidelines shall be used.

(b)Program Participant’s Liability Based on Partial Coverage. If an applicant applying for assistance under the Medically Indigent Program has gross income which exceeds the gross income limit of the applicant’s category as described above, and exceeds that limit by an amount not greater than Three Hundred Dollars ($300.00), the applicant may still be eligible for partial coverage as provided in this Section.

(c)Liability Guide. The following is a table of the percentage of a client’s liability (per visit, hospital, admission, encounter) for each range of available income per month above the income guideline: Available Income Per Month Above Income Guide Percentage Liability Guide (Client’s Liability) $ 1 - $ 50 7% $ 52 - $100 15% $101 - $150 22% $151 - $200 30% $201 - $250 37% $251 - $300 45%