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BEM 167 2 of 5 PROGRAM OF ALL INCLUSIVE CARE FOR THE ELDERLY (PACE) BPB 2023-013 7-1-2023

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

FINANCIAL ELIGIBILITY FACTORS

Groups Use fiscal and asset group policies for SSI-related groups in BEM 211. A PACE participant is a group of one even when living with a spouse. Individuals covered under the Extended Care eligibility group can be enrolled in PACE. Assets Countable assets cannot exceed the asset limit for SSI-related MA categories in BEM 400. Countable assets are determined based on MA policies in BEM 400, 401, and 402. Initial Asset Assessment (IAA) Date The special MA asset rules in BEM 402 apply when completing the initial asset assessment. The date of the medical assessment and approval for PACE enrollment is completed by the PACE agency is the first day of continuous care for the purpose of determining the IAA; unless there is a previous period of care which meets the definition of a first day of continuous care found in BEM 402. Approval means the participant expects to receive appropriate waiver services for at least 30 consecutive days. Divestment

The MA divestment policy in BEM 405 apply to PACE waiver applicants and participants.

Income Income eligibility exists when gross income does not exceed 300 percent of the federal benefit rate. Income eligibility cannot be established with a patient-pay amount or by meeting a deductible.

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Official source

BEM 167 2 of 5 PROGRAM OF ALL INCLUSIVE CARE FOR THE ELDERLY (PACE) BPB 2023-013 7-1-2023

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

FINANCIAL ELIGIBILITY FACTORS

Groups Use fiscal and asset group policies for SSI-related groups in BEM 211. A PACE participant is a group of one even when living with a spouse. Individuals covered under the Extended Care eligibility group can be enrolled in PACE. Assets Countable assets cannot exceed the asset limit for SSI-related MA categories in BEM 400. Countable assets are determined based on MA policies in BEM 400, 401, and 402. Initial Asset Assessment (IAA) Date The special MA asset rules in BEM 402 apply when completing the initial asset assessment. The date of the medical assessment and approval for PACE enrollment is completed by the PACE agency is the first day of continuous care for the purpose of determining the IAA; unless there is a previous period of care which meets the definition of a first day of continuous care found in BEM 402. Approval means the participant expects to receive appropriate waiver services for at least 30 consecutive days. Divestment

The MA divestment policy in BEM 405 apply to PACE waiver applicants and participants.

Income Income eligibility exists when gross income does not exceed 300 percent of the federal benefit rate. Income eligibility cannot be established with a patient-pay amount or by meeting a deductible.