Page 155

MEDICAL SERVICES POLICY MANUAL, SECTION E

E 435 Medicare Savings Income Calculation

Medicare Savings Income Calculation MS Manual 07/01/20 The Medicare Savings Program (MSP) recipient’s monthly countable income must meet the appropriate Federal Poverty Level (FPL) for the specific category. Refer to Appendix F for the MSP FPLs. Countable income is determined according to LTSS guidelines. For LTSS guidelines, refer to sections MS E-405-451, MS H-421 and MS H-430. Self-declaration will be accepted. Refer to MS G-115. SSI exclusions (MS E-450) will be deducted from current income to determine income eligibility. In-Kind Support and Maintenance will be considered in ARSeniors, QMB, SMB, and QI-1 determinations. For a couple, total monthly countable income will be compared to the couple’s standard in each case. If only one spouse is eligible, the procedures for deeming of income at MS E-440-445 will apply. Individuals applying for only Medicare Savings coverage will not be required to apply for SSI if their income is less than the SSI/SPA. Refer to Appendix S. If an individual does not wish to be referred to SSA and does not want to be certified for full Medicaid benefits in another Medicaid category, he/she may be certified for Medicare Savings coverage only.

Deeming Procedures MS Manual 07/01/20 For the Medically Needy, Medicare Savings Program, and SSI/COLA groups (except DAC), when the eligible applicant resides with his or her ineligible spouse or ineligible parents, deeming of income from the ineligible spouse or parent(s) is required. Deeming is the process of considering another person's income to be available for meeting an applicant's or recipient's basic needs of food and shelter. For the Nursing Facility, ARChoices, Assisted Living Facility, PACE, TEFRA, Autism, and DDS categories, deeming is not required.  NOTE: For deeming procedures for an alien sponsor, refer to MS E-300 and E-445. For deeming procedures for the Medically Needy, refer to MS O-531 through MS O-535. Deeming of Income from Ineligible Spouse MS Manual 07/01/20