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Medicaid Eligibility Manual Eligibility Factors

Reissued March 18, 2025 Replacing March 5, 2024 Page 7 of I-1660 Revised/added text indicated by underscore Deleted text indicated by “”

● Failure of the requesting couple to provide needed information.

Document in detail efforts to complete assessments timely.

Provide a copy of the assessment work sheet to the LTC/HCBS/ACH institutionalized individual and his spouse. The work sheet indicates:

● The couple's total countable resources,

● The amount that can be allocated to the community spouse, and

● The amount that will be counted for the LTC/HCBS/ACH institutionalized individual.

Note: Spousal impoverishment provisions do not apply beginning the first full calendar month following changes that result in an institutionalized spouse no longer being institutionalized or no longer having a community spouse.

Determine countable resources for each individual member of the couple. Refer to I-1630, Need - SSI-Related Resources.

I-1665 TRANSFER TO COMMUNITY SPOUSE

If resource eligibility depends on the transfer of allocated resources, and the couple intends to transfer resources:

 Complete Form 4 LTC/SP-R1 and obtain the signatures of both members of the couple acknowledging that they have been informed of their right to transfer the allocated resources to the community spouse, and

 Inform the couple:

- That allocated resources may be transferred to the community spouse without penalty, and

- That for ongoing certifications the couple will be allowed until the first renewal to effect the transfer of allocated resources.