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MEDICAL SERVICES POLICY MANUAL, SECTION E

E 433 Determining Financial Eligibility for the SSI/COLA Groups

the facility by turning over all of their assets to the home or through membership in a fraternal group or union. The value of support and maintenance provided in public or private non-profit institutions for educational or vocational training is considered as income of the individual. c. Support and maintenance provided during a medical confinement and paid to a medical provider by a third party is excluded from income for eligibility determinations. This could be in a hospital or facility. Third party payments made directly to a facility as payment for items covered by the facility vendor payment will be considered as income in the computation of the patient’s share of the vendor payment. If third party payments are made to cover special charges or additional services and items not covered by the LTSS program, they will not be considered as income. d. The value of support and maintenance provided by a private for profit nonmedical retirement home or similar facility whichdoes not receive third party payments on behalf of an individual is not considered as income of the individual. The value of support andmaintenance in such facilities is considered if third party payments are being made on behalf of the individual. e. Occasional in-kind items of little value (not exceeding $20.00 in a month) are excluded when they are received irregularly or infrequently.

Determining Financial Eligibility for the SSI/COLA Groups MS Manual 07/01/20 In determining income eligibility, the SSI related income criteria in the MS E-400-451 section will be used to determine eligibility for the following groups: PICKLE All SSA COLA increases received since loss of SSI benefits will be disregarded, including the initial SSA COLA increase which resulted in loss of SSI. (Other types of SSA benefit increases and other changes in income and resources will not be disregarded.) The $20 general exclusion and other SSI exclusions (Re. MS E-450) will also be deducted from current income.