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State of Maryland Medical Assistance Manual Revised April 2014

determine how much of the couple’s resources are to be protected for use by the community spouse and how much is to be considered available to the institutionalized spouse in the eligibility determination. The amount to be protected for the community spouse is a spousal share of at least the minimum but not more than the maximum spousal share listed in Schedule MA-8. If the spousal share exceeds the maximum amount allowed, the excess will not be protected, but will be considered available to pay towards the cost of care for the institutionalized spouse. If the spousal share is less than the minimum amount allowed, more of the couple’s resources will be attributed to the community spouse to allow that spouse to retain an amount as close to the minimum spousal share as possible. While these guidelines are established by federal law, a court-ordered support arrangement or the decision of an Administrative Law Judge would take precedence over these amounts. The amounts to be attributed are determined at the time of application for Medical Assistance. To determine these amounts, the CM must: 1. Establish the couple’s total combined countable resources as of the month of application; 2. Deduct from the above figure the greater of: • The spousal share (determined in the resource assessment) not to exceed the maximum (Schedule MA-8); • The community spouse minimum spousal share; or • The amount ordered by a court or a hearings officer. The figure selected in this step is the amount to be protected for the community spouse. 3. The remainder is the amount to be attributed to the institutionalized spouse. Compare this to the Schedule MA-2 for one person. When the remaining resources are equal to or less than the amount in Schedule MA-2, the institutionalized spouse is resource eligible. If the remaining resources are above the standard, the institutionalized spouse is not eligible. When the resources exceed Schedule MA-2, the institutionalized spouse is ineligible until the couple’s total combined countable resources are reduced to the sum of: • The amount to be protected for the community spouse (Step 2 above); plus • The resource standard (Schedule MA-2) for the institutionalized person. The excess resources must be used to pay for the cost of care or other documented medical or personal expenses. Once an institutionalized spouse has been determined eligible, beginning with the second month of eligibility, only those resources held in the institutionalized spouse’s name are used for future redeterminations, and resources owned by the community spouse are not considered available to the institutionalized spouse. Those resources owned by the institutionalized spouse will continue to be compared to the Schedule MA-2 standard for one person. After the initial eligibility determination has been made, resources attributed to the community spouse must be legally transferred to that spouse when they are not already in his/her name. The resources must actually be made available to the community spouse (i.e. must be