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AGED, BLIND, AND DISABLED MEDICAID 015 Table of Standards: Standard Payment Amounts (SPA) Supersedes: ABD 015 (01/01/2020) Reference: 20 CFR 416.410 and .412; ARM 37.82.101 Overview: The Standard Payment Amount (SPA) is allotted to eligible Supplemental Security Income (SSI) clients to maintain a standard of living at the established federal minimum income level. The SPA is based on whether the individual is living independently, in the household of another or in a medical institution. INDEPENDENT LIVING ARRANGEMENT: A living arrangement where the person is self-sufficient and does not rely upon another or an institution to provide food and/or shelter. IN ANOTHER’S HOUSEHOLD: A living arrangement where both shelter and food are provided to an individual either directly by another person or entity or by virtue of payment for both shelter and food by another person or entity. STANDARD PAYMENT AMOUNT Effective: January 1, 2021 LIVING ARRANGEMENT INDIVIDUAL COUPLE Independent living arrangement $841.00 $1261.00 In the household of another $584.00 $845.00 In a medical institution $30.00 $30.00 each

Effective Date: January 1, 2022