Policy History for 5.8.5 FINANCIAL

Release 04-03

(1) Assets

 

Refer to (4.5.1)  to determine when an asset is countable.  If countable assets exceed the appropriate limit, the Medicaid applicant/recipient is ineligible.
 

    1. Unmarried client.
      See 8.1.5 for the EBD asset limits for an unmarried client.
       

    2. Married client ( Spousal Impoverishment ) The assets of both the institutionalized person  and his/her community spouse are counted in the initial asset test.  For information about how to determine a married client’s asset limit and the community spouse asset share refer to (5.10.4).

 

(2)  Income .

 

Follow the policies listed in 4.1 to determine an applicant’s income. The income limit is the same for non-spousal impoverishment institutionalized persons as for spousal impoverishment cases. But, for spousal impoverishment cases, after the institutionalized person becomes eligible, s/he is allowed to allocate some of his/her income back to his/her community spouse. (5.10.6)

 

If income is greater than Institutions Categorically Needy Income Limit (8.1.5) the person is ineligible for categorically needy MA.

 

If the income is greater than need (5.8.6) the person is ineligible for medical needy MA.

 

Sometimes, when both spouses are institutionalized, the income of one is greater than his/her monthly need and the income of the other is less than his/her monthly need.  When this occurs, calculate the couple’s combined monthly need and compare it with their combined income.  If the total need is greater than the total income, and if the spouse with greater income is willing to combine it with his/her spouse’s lesser income, both spouses could be eligible.

 

5.8.5.1 Divestment

 

See  4.7 for Divestment policies.

 

5.8.5.2  Instructions for Manual Eligibility Determinations

Use the following to determine which financial worksheet to use:

 

  1.  Medical institution  (5.8.1) residents with no community spouse (5.10.2.1).  

    Use the MA Institution Worksheet (Worksheet #4).
     

  2. Medical institution residents who have a community  spouse and who became institutionalized before 9-30-89:

 

Use the HCF 10095 Medicaid Asset Assessment Medical Institution/Community Waiver Resident and Community Spouse Form and the MA Institution Worksheet (Worksheet #4).
 

  1.  Medical institution residents who have a community spouse and who became institutionalized on or after 9- 30-89:

    Use the HCF 10095 Medicaid Asset Assessment Medical Institution/Community Waiver Resident and Community Spouse Form and the Spousal Impoverishment Income Allocation Worksheet (Worksheet #7).
     

  2. Community waiver applicants with no community spouse:

 

Use the HCF 10095 Medicaid Asset Assessment Medical Institution/Community Waiver Resident and Community Spouse Form.
 

  1.  Community waiver applicants with a community spouse:

 

Use the HCF 10095 Medicaid Asset Assessment Medical Institution/Community Waiver Resident and Community Spouse Form.

 

 

This page last updated in Release Number : 04-03

Release Date: 08/02/04

Effective Date: 08/02/04