Policy History for 5.8.4 DEFINITIONS

Release 07-02

5.8.4 DEFINITIONS

5.8.4.1 Institutionalized Person

5.8.4.2 Community Spouse

5.8.4.3 SSI Recipient and Institutional MA application

5.8.4.1 Institutionalized Person

“Institutionalized person” means someone who:

 

  1. Has resided in a medical institution for 30 or more consecutive days, or

  2. Is likely to reside in a medical institution for 30 or more consecutive days, as attested to by the medical institution.

 

For purposes of divestment and spousal impoverishment, consider community waivers participants to be institutionalized.

 

An exception to the 30-day period is that a resident of an IMD Institute for Mental Disease is considered an institutionalized person until s/he is discharged.

 

The 30-day period includes situations in which the person resides in more than one medical institution during 30 or more consecutive days.

 

5.8.4.2 Community Spouse

A “community spouse” is:
 

  1. Married to an institutionalized person, and

  2. Not living in a nursing home or other medical institution for 30 or more consecutive days.

 

5.8.4.3 SSI Recipient and Institutional MA application

An SSI recipient who has resided or is likely to reside in a medical institution for 30 days or more may apply and be non-financially eligible for institutional Medicaid if the SSA will discontinue the person's SSI because of the financial effect of his/her residence in the medical institution.

 

An SSI recipient who has not resided or is not likely to reside in a medical institution for 30 days or more is non-financially ineligible for institutional Medicaid.  The person remains Medicaid eligible through SSI.

 

 

This page last updated in Release Number : 04-03

Release Date: 08/02/04

Effective Date: 08/02/04