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The policies in this section apply to the MA A, MA B, MA D, MADW, and MADI categories of assistance.

A post-eligibility budget is to be completed for the individual who passes the eligibility determination and is in a Medicaid certified long-term care (LTC) facility or hospital. Post- eligibility is not completed for the individual who resides in his home not receiving HCBS waiver services or who resides in a non-Medicaid certified facility. Also, a post-eligibility budget is not completed for the individual who is disapproved for nursing home placement (Level of Care or Preadmission Screening denial) or who is serving a transfer of property penalty. When a MEDWorks recipient is subject to post-eligibility budgeting in a Medicaid certified facility, there is no premium charged, because a liability is applicable. The rules for when to apply the Special Income Limit (SIL) are same for married or single applicants who meet any of the following criteria: • Have been in a Medicaid-certified facility for at least 30 days • Are expected to be in such an institution for at least 30 days • Are approved for one of the HCBS Waivers listed in 3305.00.00. The SIL budget should apply beginning with the month where a member had at least one day where they met A-C criteria (above), or the first month being explored for retroactive eligibility, whichever is later.

Liability will be applied as of the first month where the member was in the facility on the 1st day of that month. For example, if a member entered a nursing facility on 09/15/17, a Medicaid application was submitted 12/01/17 and approved for all retro months. A zero liability would be displayed for 09/01/17 with the liability forming 10/01/17 ongoing. For recipients who are discharged from an LTC facility, the eligibility budget is applicable in the month following the month of discharge in accordance with change processing guidelines in Chapter 2200. When a recipient enters a hospital from his home the DFR will have to determine the anticipated length of his hospital stay. If it is expected that the hospital stay will continue for at least a full calendar month, a post-eligibility budget is required in accordance with change processing requirements in Chapter 2200. It is a general rule that the surplus income from the post-eligibility budget is a "liability”. A liability is designated for the individual who is residing in an LTC facility or hospital if the stay will continue for at least 30 consecutive days. The liability is the amount which Medicaid will not pay to the facility each month. If an individual dies prior to reaching 30 consecutive days, the