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Title 8: Medicaid Page 13 Iowa Department of Health and Human Services Employees’ Manual Chapter D: Resources Attribution of Resources Revised July 10, 2026 Calculating the Amount to Attribute to the…

In this situation for client participation, Mrs. D has a $2,531.50 deficit of income and Mr. D has no income left to divert to Mrs. D. If Mr. D had income left after the spousal diversion, this is when you would allow other deductions in the CP calculation, such as unmet medical needs (Medicare and health insurance premiums). NOTE: Do not annualize the community spouse’s income when determining the diversion to the community spouse in the client participation calculation. The appellant must obtain one estimate of the cost of a single-premium lifetime annuity, based on the community spouse’s age at the time of appeal, that would generate income equal to the difference between:  The couple’s available gross income and  The MMMNA in effect when the appeal was filed. Neither the applicant nor the community spouse has to purchase an annuity as a condition of Medicaid eligibility. If the applicant is unable to obtain one estimate, assist the couple by contacting financial institutions. If the institution requires the identity of the applicant, obtain a release of information from the applicant. If the financial institution is unable to provide an estimate, determine the shortfall between the couple’s available gross income and the MMMNA. Multiply the shortfall by 12. Multiply this amount by the community spouse’s “Life Expectancy in Years” row from the Table for an Annuity for Life from the Mortality Table issued by the Iowa Department of Revenue. (See next page.) Formula: (MMMNA – couple’s available gross monthly income) x 12 x community spouse’s life expectancy in years = single-premium lifetime annuity quote. Complete form 470-3144, Attribution of Resources Appeal Summary according to instructions in 6-Appendix. Report the verified available income of the couple. Note and estimate the amount of any benefits for which the community spouse is eligible but is not receiving. Attach copies of the annuity bid to the form. Send the form to the Appeals Section, 321 E. 12th Street, Des Moines, Iowa 50319.