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State of Maryland Medical Assistance Manual Revised April 2014

application form to collect the information necessary to calculate the available income. (See Policy Alert 10-08 for redetermination procedures when SSI recipients enter LTC.) Income that is received on a regular basis in a constant amount is considered based on documentation from the source of income. This includes benefits such as Social Security, pensions, V.A. benefits, etc. The CM should set an alert to verify income that has an annual cost of living increase. Income that is variable in amount, or is received less frequently than once a month, is projected throughout the period under consideration based on the amounts received in the twelve months prior to the period under consideration, or on projections documented by the source of such income. This projection for the period under consideration is then converted to average monthly amounts. This type of income includes interest, dividends, one-time-only income, lump sum benefits, etc. For current eligibility, the total monthly income equals the monthly amount of regular income plus the average monthly amount of variable income. For a retroactive month, total monthly income is the amount actually received in the month. (i) Determining Monthly Available Income To determine monthly available income, begin with the total monthly income as determined above and deduct the following, in the following order (see Schedule MA-8 for the current amounts): • A Personal Needs Allowance; • A Residential Maintenance Allowance; • A Spousal Allowance; • Either a Family Allowance for minor or dependent children, dependent parents, or dependent siblings of the institutionalized or community spouse who are residing with the community spouse; or a Dependent Allowance, as appropriate; • Incurred expenses for medical care or remedial services for the institutionalized spouse that are not subject to payment by a third party, including: o Medicare and other health insurance premiums, deductibles or co-insurance charges; and o Necessary medical care or remedial services recognized under State law but not covered under the Medical Assistance State Plan for the recipient. The personal needs allowance is always deducted first, to ensure that the institutionalized person has this money available to him/her even if the remaining income is insufficient to cover the other deductions. To determine which deductions are applicable and the appropriate amount of each deduction, use the following guidelines: 1. Personal Needs Allowance