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BAM 600 43 of 50 HEARINGS BPB 2026-014 5-1-2026

BRIDGES ADMINISTRATIVE MANUAL STATE OF MICHIGAN DEPARTMENT OF HEALTH & HUMAN SERVICES

An example of exceptional circumstances is the need for the com- munity spouse to pay for supportive and medical services at home to avoid being institutionalized. Significant financial duress does not exist if the community spouse could meet expenses using their assets. This includes assets pro- tected for the community spouse's needs as the protected spousal amount. The ALJ may also grant a greater protected spousal amount (BEM 402, Special MA Asset Rules) when necessary to raise the commu- nity spouse's income to the total allowance for the community spouse. The community spouse's income for this purpose includes the maximum amount the long-term care facility and/or hospital (L/H) client could make available to their community spouse per BEM 546. When the ALJ grants a greater amount in the above circumstances, the final decision specifies: • The amount of the protected spousal amount; see BEM 402, Special MA Asset Rules. • The total allowance in BEM 546, Post-Eligibility Patient-Pay Amounts, used for the community spouse when determining the community spouse income allowance. • The assets to be transferred for use by the community spouse. • When another hearing will be held to review the exceptional circumstances. If exceptional circumstances no longer exist before the case is due for the follow-up hearing, send the information to MOAHR. Be sure to include the register number of the last D&O. MOAHR will then decide whether to reschedule that hearing. Additional Low- Income Medicare Beneficiaries (ALMB) MA Only The ALJ cannot order prior months of ALMB eligibility when the prior month(s) is before January of the current calendar year.