Income and Shelter Calculator

Applicant Income Sources
Description Monthly Amount
TOTAL
Allowable Assets
Medical Insurance
TOTAL
Personal Needs
Available Income

Spouse Income Sources
CSRA
Description Monthly Amount
Actual Income
CSRA Income 1.5%
TOTAL

Shelters

Rent
Mortgage
Taxes County
Taxes Local
Taxes School
Home Owners Ins
Condo Fees
Utility Allowance
TOTAL
Shelter Standard
Excess
Minimum MMNA
Spousal MMNA
Over Max MMNA!
Amount Over:
Spousal Income
Spousal Needs

Current Medicaid Numbers

Year
NMP Income
Minimum MMNA
Maximum MMNA
Shelter Standard
SUA Heat
SUA No Heat

Results

IS Available Income
Paid to Spouse
Patient Pay
CS Income
IS Income to CS
CS Income Received