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COMAR 10.09.24.03

343 State of Maryland Medical Assistance Manual Revised July 2012 -425.00

$ -0-

c. Mr. P‟s net income of $395 is within the QMB income standard of $425.0. His resource is within the QMB resource standard of $4000.00. d. Decision: Mr. P is eligible for the Buy-In coverage.

Example II:

Mrs. K a disabled Medicare Beneficiary, applies for the Medicare buy-in coverage. She lives with her husband and two children, ages 8 and 10 years old. Since Mrs. K has requested Buy-In coverage only, hers is a one-person, ABD AU.

Mrs. K and her two children receive OASDI ($325 and $135 monthly, per child, respectively). Mr. K is employed and receives $525 weekly.

The family has countable resources of $3800; therefore, Mrs. K is resource eligible. To determine Mrs. K‟s income eligibility, the income of Mr, K must be taken into account.

Take the following steps to determine if any of Mr. K‟s income is deemed to be available to Mrs. K.

Step 1-Determination of Mr. K‟s Countable Income

Multiply Mr. K‟s weekly E. by 4.3 to arrive at monthly income, and apply the $20.00 ABD general and E.I ($65.00-½ of remainder) disregards. (If paid bi-weekly multiply income by 2.15 to arrive at monthly income.)

Mr. K‟s U.I. $0.00 $525.00 Mr. K‟s E.I.

×4.3

2257.50

-20.00

2237.50 -65.00 $2172.50÷2=$1086.25

Step 2-Determination of Income to be deemed from Ineligible Spouse (Mr. K) (Income allocation for ineligible child-differences between SSI payment rate for couple and an individual):