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BEM 164 2 of 3 EXTENDED-CARE BPB 2020-021 7-1-2020

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

BEM 270, Pursuit of Benefits. FINANCIAL ELIGIBILITY FACTORS

Groups Use fiscal and asset group policies for SSI-related MA groups in BEM 211. Assets Countable assets cannot exceed the asset limit in BEM 400. Countable assets are determined based on MA policies in BEM 400, 401 and 402. Divestment Policy in BEM 405 applies. Income Eligibility Income eligibility exists when gross countable income does not exceed 300 percent of the SSI benefit rate. Apply the MA policies in BEM 500, 501, 502, 503, 504 and 530 to determine gross income. Do not apply the deductions in BEM 540 and 541. Income eligibility cannot be established with a patient-pay amount or by meeting a deductible. Third Party Liability Complete MSA-1354 for clients with other insurance including long term care/nursing home insurance and submit with a copy of insur- ance card if available. Patient Pay Offsets If an LTC applicant requests an offset of their patient pay to cover old medical bills, see Pre-Eligibility Medical Expense (PEME) in glossary and BEM 546.

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Official source

BEM 164 2 of 3 EXTENDED-CARE BPB 2020-021 7-1-2020

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

BEM 270, Pursuit of Benefits. FINANCIAL ELIGIBILITY FACTORS

Groups Use fiscal and asset group policies for SSI-related MA groups in BEM 211. Assets Countable assets cannot exceed the asset limit in BEM 400. Countable assets are determined based on MA policies in BEM 400, 401 and 402. Divestment Policy in BEM 405 applies. Income Eligibility Income eligibility exists when gross countable income does not exceed 300 percent of the SSI benefit rate. Apply the MA policies in BEM 500, 501, 502, 503, 504 and 530 to determine gross income. Do not apply the deductions in BEM 540 and 541. Income eligibility cannot be established with a patient-pay amount or by meeting a deductible. Third Party Liability Complete MSA-1354 for clients with other insurance including long term care/nursing home insurance and submit with a copy of insur- ance card if available. Patient Pay Offsets If an LTC applicant requests an offset of their patient pay to cover old medical bills, see Pre-Eligibility Medical Expense (PEME) in glossary and BEM 546.