[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-1-en-105":3,"doc-seo-306306-105":53,"doc-detail-306306-en":119},{"code":4,"msg":5,"data":6},0,"success",[7,14,19,24,29,34,39,44,49],{"id":8,"doc_module":9,"doc_module_name":10,"category_name":11,"show_sort_weight":12,"slug":13},11,1,"Template","Presentations",90,"presentations",{"id":15,"doc_module":9,"doc_module_name":10,"category_name":16,"show_sort_weight":17,"slug":18},12,"Resumes",80,"resumes",{"id":20,"doc_module":9,"doc_module_name":10,"category_name":21,"show_sort_weight":22,"slug":23},14,"Invoices",70,"invoices",{"id":25,"doc_module":9,"doc_module_name":10,"category_name":26,"show_sort_weight":27,"slug":28},15,"Posters",60,"posters",{"id":30,"doc_module":9,"doc_module_name":10,"category_name":31,"show_sort_weight":32,"slug":33},16,"Social Media",50,"social-media",{"id":35,"doc_module":9,"doc_module_name":10,"category_name":36,"show_sort_weight":37,"slug":38},17,"Forms",40,"forms",{"id":40,"doc_module":9,"doc_module_name":10,"category_name":41,"show_sort_weight":42,"slug":43},18,"Letters",30,"letters",{"id":45,"doc_module":9,"doc_module_name":10,"category_name":46,"show_sort_weight":47,"slug":48},21,"Paper Templates",5,"papers-templates",{"id":50,"doc_module":9,"doc_module_name":10,"category_name":51,"show_sort_weight":4,"slug":52},158,"General","general-158",{"code":4,"msg":54,"data":55},"ok",{"site_id":56,"language":57,"slug":58,"title":59,"keywords":60,"description":61,"schema_data":62,"social_meta":112,"head_meta":114,"extra_data":116,"updated_unix":118},105,"en","q-track-course-budget-sheet-sample-applications","Q-Track Course - Budget Sheet & Sample Applications","","Q-Track course package with Medicaid budget-sheet forms and worked examples across individual and couple scenarios. Covers Form 172 Budget Sheets and includes sample applications for Tracey Smith and for Jon & Sara Montgomery. Provides computation guidance for ABD Medicaid individual calculations, deeming from an ineligible spouse, and spouse-to-spouse/couple deeming, including income deductions, surplus/deficit handling, and AMN spenddown decision rules tied to Q-Track eligibility.",{"@graph":63,"@context":111},[64,80,102],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":36,"@type":70,"position":76},"https://docshare.wps.com/template/forms/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/q-track-course-budget-sheet-sample-applications/306306/",4,{"url":78,"name":59,"@type":81,"image":82,"author":87,"headline":59,"publisher":90,"fileFormat":93,"inLanguage":57,"description":61,"dateModified":94,"datePublished":95,"encodingFormat":93,"isAccessibleForFree":96,"interactionStatistic":97},"DigitalDocument",{"url":83,"@type":84,"width":85,"height":86},"https://docshare.wps.com/thumbnails/q-track-course-budget-sheet-sample-applications/306306.png","ImageObject",442,249,{"name":88,"@type":89},"Clementine","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/pdf","2026-10-23","2026-09-19",true,{"@type":98,"interactionType":99,"userInteractionCount":101},"InteractionCounter",{"@type":100},"ViewAction",9,{"@type":103,"mainEntity":104},"FAQPage",[105],{"name":106,"@type":107,"acceptedAnswer":108},"How is Q-Track eligibility determined in the worksheet notes?","Question",{"text":109,"@type":110},"For Q-Track eligibility, the A/R must be eligible for the COA as an individual (Section A) to meet eligibility for the same COA as an individual with an ineligible spouse (Section C). The notes give an example where eligibility differs between individual and deemed scenarios.","Answer","https://schema.org",{"og:url":78,"og:type":113,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":115,"canonical":78},"index,follow",{"doc_id":117,"site_id":56},306306,1791159181,{"code":4,"msg":5,"data":120},{"doc_id":117,"user_id":121,"nickname":88,"user_avatar":122,"doc_module":9,"category_id":35,"category_name":36,"doc_title":59,"doc_description":61,"doc_content":123,"file_id":124,"file_url":125,"file_type":126,"file_size":127,"view_count":101,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":45,"language":128,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":129,"faqs":130,"seo_title":131,"seo_description":61,"update_tm":132,"read_time":133},1374391974564,"https://ap-avatar.wpscdn.com/avatar/14000253aa45c000a9e?x-image-process=image/resize,m_fixed,w_180,h_180&k=1779874745381141002","This package includes the course material that you will need for the Q-Track  \nCourse. It is 21 pages, and includes the following:  \n\n| TOPIC | Page |\n| --- | --- |\n| Form 172, Budget Sheets | 2-3 |\n| Sample application: Tracey Smith | 4-11 |\n| Sample application: Jon & Sara Montgomery | 12-21 |\n\nABD Medicaid Individual/Couple/Spouse to Spouse Deeming Budget Sheet  \nAU Name:   AU \\#   Class of Assistance:   Living Arrangement:   Date:    \n\n| Section A-Individual Calculation: Use to budget a Medicaid Individual OR a Medicaid Individual with an Ineligible Spouse (Spouse to Spouse Deeming) in LA-A or LA-B. Not for use on Medicaid Cap budgeting. | Mo/Yr | Mo/Yr | Mo/Yr |  |\n| --- | --- | --- | --- | --- |\n| UNEARNED INCOME |  |  |  |  |\n| 1. Enter A/R’s Total GROSS Unearned Income |  |  |  |  |\n| 2. Subtract $20 General Deduction. (Subtract $0 from IBON) |  |  |  |  |\n| 3. Net Unearned Income (Line 1 minus Line 2) |  |  |  |  |\n| Earned Income (Go to Line 11 if no earned income) |  |  |  |  |\n| 4. Enter A/R’s Total GROSS Earned Income. |  |  |  |  |\n| 5. Subtract remainder of $20 General Deduction. |  |  |  |  |\n| 6. Subtotal (Line 4 minus Line 5) |  |  |  |  |\n| 7. Subtract $65 Earned Income Deduction. |  |  |  |  |\n| 8. Subtotal (Line 6 minus Line 7) |  |  |  |  |\n| 9. Subtract ½ of Line 8. |  |  |  |  |\n| 10. Subtotal (Line 8 minus Line 9) |  |  |  | AMN 3\u003Cbr>Mo BP |\n| TOTAL INCOME |  |  |  |  |\n| 11. Total Net Income (Line 3 plus Line 10) |  |  |  |  |\n| 12. INDIVIDUAL Income Limit (FBR, Q-track, MNIL) |  |  |  |  |\n| 13. Surplus/Deficit OR 1st Potential AMN Spenddown (Line 11 minus Line 12) |  |  |  |  |\n\nNOTE: If a surplus exists on Line A.13, STOP (the A/R is ineligible) unless AMN. If a deficit exists or the COA is AMN, continue. NOTE: For Q-Track eligibility, A/R must be eligible for the COA as an individual (Section A), in order to meet eligibility for the same COA as an individual with an ineligible spouse (Section C) . Example: A/R is SLMB eligible as an individual (Section A) but appears to be QMB eligible under Spouse to Spouse Deeming budget (Section C) . A/R will only eligible for SLMB, since s/he is ineligible for QMB as an individual.  \n\n| Section B-Deeming From Ineligible Spouse: Use to budget a Medicaid Individual with an Ineligible Spouse (Spouse to Spouse Deeming) in LA-A or LA-B. | Mo/Yr | Mo/Yr | Mo/Yr |\n| --- | --- | --- | --- |\n| UNEARNED INCOME |  |  |  |\n| 1. Enter Ineligible Spouse’s GROSS UNEARNED Income (Exclude IBON) |  |  |  |\n| 2. Subtract Living Allowance for Ineligible Child(ren) minus the Child(ren)’s Income |  |  |  |\n| 3. Ineligible Spouse(s)’ UNEARNED Income to include in Section C (Line 1 minus Line 2) |  |  |  |\n| Earned Income |  |  |  |\n| 4. Enter Ineligible Spouse(s)’ GROSS EARNED Income. |  |  |  |\n| 5. Subtract any portion of Living Allowance not subtracted from Unearned Income. |  |  |  |\n| 6. Ineligible Spouse(s)’ EARNED Income to include in Section C (Line 4 minus Line 5) |  |  |  |\n\nSee REVERSE SIDE for Continuation of Budgeting  \nAMN Only: If the combined total of Lines B.3 and B.6 does NOT exceed ½ the Individual MNIL, STOP and use the 1st Potential Spenddown from Line A.13 as the AMN Spenddown.  \n\n| Section C-Spouse-to-Spouse Deeming or Couple Calculation: Use to budget a Medicaid Individual with an Ineligible Spouse (Spouse to Spouse Deeming) OR a Medicaid Couple in LA-A or LA-B. | Mo/Yr | Mo/Yr | Mo/Yr |  |\n| --- | --- | --- | --- | --- |\n| UNEARNED INCOME |  |  |  |  |\n| 1. Enter Total GROSS Unearned Income of A/R and Unearned Income deemed from Ineligible Spouse (Line A.1 plus UNEARNED Income from Line B.3) OR Total GROSS Unearned Income of Medicaid Couple. |  |  |  |  |\n| 2. Subtract $20 General Deduction. (Subtract $0 from IBON) |  |  |  |  |\n| 3. Net Unearned Income (Line 1 minus Line 2) |  |  |  |  |\n| Earned Income (Go to Line 11 if no earned income) |  |  |  |  |\n| 4. Enter Total GROSS Earned Income of A/R and Earned Income deemed from Ineligible Spouse (Line A.4 plus","cbCaibz0IZwpKrjp","https://ap.wps.com/l/cbCaibz0IZwpKrjp","pdf",1080969,"English","# Form 172, Budget Sheets\n## Sample application: Tracey Smith\n## Sample application: Jon & Sara Montgomery\n# ABD Medicaid Individual/Couple/Spouse to Spouse Deeming Budget Sheet\n## Section A-Individual Calculation\n## Section B-Deeming From Ineligible Spouse\n## Section C-Spouse-to-Spouse Deeming or Couple Calculation\n# Georgia Application for Medicaid & Medicare Savings for Qualified Beneficiaries\n## Instructions for completing and submitting the application","[{\"question\":\"How is Q-Track eligibility determined in the worksheet notes?\",\"answer\":\"For Q-Track eligibility, the A/R must be eligible for the COA as an individual (Section A) to meet eligibility for the same COA as an individual with an ineligible spouse (Section C). The notes give an example where eligibility differs between individual and deemed scenarios.\"}]","Q-Track Course - Budget Sheet & Sample Applications | PDF",1789835199,7]