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COMAR 10.09.24.03

339 State of Maryland Medical Assistance Manual Revised July 2012

NOTE: For the purpose of this release, the terms “ineligible spouse” and “ineligible child” apply to one who is not receiving or entitled Medicare.

Assistance Unit Requirements

An AU unit may include only a person who is a Medicare beneficiary. In the case of a married couple both of whom are Medicare beneficiaries; both spouses are included in the same unit and their eligibility is tested together as a couple. Otherwise, the unit will include only one person. If only one of the married couple is a Medicare beneficiary, only the Medicare beneficiary is included in the unit. However, the income and resources of the ineligible spouse are considered. (Total countable resources of a couple are combined and measured against the QMB resource standard for two persons). Children are not counted in the resource measurement. Refer to Attachment A, 2012 Dual Eligible Standards. Refer to Section G for income deeming requirements.

Note: Ineligible Spouse applies to one who is not receiving or entitled to Medicare.

Determination of Countable Income

Countable income is evaluated in accordance with COMAR 10.09.24.07. The countable income to be considered is that of the assistance unit member(s) (Medicare beneficiary/ beneficiaries) or, in the case of an ineligible spouse, that of the ineligible spouse as well. The exclusions and disregards apply to the income that is considered available to the Medicare beneficiary, including that of the ineligible spouse. The Social Security cost-of-living adjustments (COLAS), effective January, are to be disregarded in determining income eligibility through April. The first month in which the COLAS are to be applied is May. Countable income, after disregards, is measured against the QMB income standard. If a Medicare beneficiary has an ineligible spouse and ineligible children, the income of the ineligible spouse must be considered in determining the Medicare beneficiary‟s eligibility. The procedures for determining the amount of the ineligible spouse‟s income to be deemed to the Medicare beneficiary spouse are in Section G of this part.

Resource Consideration

The countable resources to be considered are those of the applicant and the spouse of the applicant whether or not the spouse is also eligible. Countable resources are measured against the QMB resource standard for one person if the Medicare beneficiary has no spouse, or against the QMB resource standard for two persons if there is a spouse.

No other family members are included in the measurement. If there are excess resources, the individual or couple is determined ineligible. Deem Income from an Ineligible Spouse to a Medicare Beneficiary