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June 2021

L01—EMS L01—ImpaCT

2540.88

HUSKY C LTCF Residents Eligible Under Special Income Level (CN)

• Meet categorical requirements of age, blindness or disability AND • Reside in the LTCF facility for at least 30 days AND • Have income below special income level • Must meet level of care as determine by ASCEND/AssessmentPro

Compare gross income to special CNIL (300% of SSI amount)

Use AABD asset level (currently $1,600)

Special income deduction and asset rules apply if spouse resides in community Begins with 1st day of 30 continuous days of residence in the LTCF as long as eligibility factors are met L99—EMS L99—ImpaCT

2540.88 2540.88P HUSKY C MN LTCF Residents

• Same as L01, but income is greater than CNIL • L01 will cascade to this coverage group if not CN.

• MNIL is used and spenddown process - uses nursing home cost of care. • Use AABD asset level (currently $1,600) • Special income deduction and asset rules apply if spouse resides in community Same as L01