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Medical Services Policy Manual, Section H

H 400 Post Eligibility

H-400 Post-Eligibility MS Manual 08/29/22 The eligibility groups Nursing Facility, Assisted Living Facility, PACE recipients in a nursing facility, and PACE recipients in the community who have met income eligibility by establishing a Miller Income Trust all require certain procedures to complete the determination of eligibility. These eligibility procedures are explained in the following sections. H-401 Income Eligibility Determination for the Institutionalized Spouse (IS) MS Manual 07/01/20 Income eligibility for the IS will be determined in general following the procedures in MS H-402-430. Gross income of the IS cannot exceed the current Long-Term Services and Supports (LTSS) income limit in determining eligibility, unless an income trust has been established. Income of the Community Spouse (CS) will not be deemed to the IS in any month or partial month of institutionalization. If an IS is receiving full SSI payment for the first three months of institutionalization, the SSI payment will be disregarded as income. Refer to MS H-420. H-402 Consideration of Income MS Manual 08/29/22 After the IS has been determined to be resource eligible for Long-Term Services and Supports (LTSS), income of the IS and CS will be considered as follows: 1. Income Not From A Trust • Income received solely in the name of either spouse will be considered income only to that spouse. Refer to MS E-432 #5 for “Veteran’s Benefits” exceptions. • If payment of income is made in the names of both the IS and CS, half will be considered available to the CS and half to the IS. • If payment of income is made in the names of the IS or the CS or both and another person, the income will be considered available to each spouse in proportion to each spouse’s interest. If payment is made with respect to both spouses, and no such interest is specified, one half (1/2) of the joint interest will be considered available to each spouse.