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Chapter: 2200 Standard Filing Unit Program: MSSI, SFP 37

2240.0611 Couple/Both Request Medicaid (MSSI) The following policy is applicable only to MEDS-AD, EMA, Protected Medicaid, Medically Needy and Working Disabled Programs.

If an eligible individual is living with an eligible spouse, the income standard for two must be used. Eligibility as a couple must be determined using both spouses' income and assets.

Income is not allocated to family members or dependents.

If an eligible individual is living with their ineligible spouse, the income and assets must be deemed from the spouse who is not eligible for or requesting assistance. If there is not enough income to be deemed, the income standard for one must be used. If there is enough income to deem, the individual must first pass the individual test for one. If they pass the individual income test, they must also pass the couple standard using deemed income from the spouse.

Regardless of the income standard used, the asset standard for a couple must be used.

The following policy is applicable only to QMB, SLMB, QI-1. If an eligible individual is living with an eligible spouse, the income and asset standard for two must be used. Eligibility as a couple must be determined using both spouses' income and assets. 2240.0612 Couple/One Requests Institutional Care Services (MSSI) The following policy is applicable only to ICP, MEDS-ICP, PACE and Institutional Hospice Programs. If an individual has a community spouse and only one spouse is requesting institutional services, the income standard for one is used. Only the institutionalized individual's income is used to determine his income eligibility.

At the time of application, the total countable assets of both spouses are considered and an amount is allocated to the community spouse in accordance with policies in Chapter 1600.

After eligibility is established, income may be allocated to the legal spouse, family member, and dependents in accordance with policy in Chapter 2600. 2240.0613 Eligible Couple/Both Request ICP, HCBS, Hospice, SFP (MSSI, SFP) The following policy is applicable only to individuals living with their spouse and both are requesting (or receiving) ICP, MEDS-ICP, PACE, HCBS, Institutional Hospice, Community Hospice, or OSS. To apply the couple standards, both individuals must first meet the technical criteria for the program.

If the couple both live in the same home or institution, they are considered living together for purposes of this policy. The individuals can choose whether to be considered as a couple or as individuals, whichever is to their advantage. The income standard for two must be used and income and assets counted together if determining eligibility as a couple. If they choose to be treated as individuals, the income standard for one must be used and each individual's income and assets must be treated separately.

Income to dependents and family members must be allocated except in the HCBS Program, for which you do not allocate income to dependents or family members. (Refer to Chapter 2600 for appropriate allocation policies.)