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2. Married living together in Assisted Living even if one or both spouses receive Medicaid waiver coverage. (Spousal impoverishment does not apply to MSP eligibility). 3. Married living together: one in the community and one waiver spouse. NONFINANCIAL REQUIREMENTS: Medicaid standard nonfinancial requirements are listed in section CMA 300. In addition to the standard criteria that applies to all Medicaid programs, the following nonfinancial criteria are specific to all MSP programs: · Must be enrolled in Medicare Hospital Insurance (Part A)

Qualified Individual additional criteria · Other medical coverage (i.e., medically needy) cannot be issued with QI for more than one month NOTE: QI continues when a QI recipient requests and meets medically needy eligibility for only one month. FINANCIAL REQUIREMENTS: Countable income must be within the following guidelines for the appropriate household size: QMB: at or below 100% FPL SLMB: above 100% and at or below 120% FPL QI: above 120% and at or below 135% FPL Countable resources cannot exceed the MSP resource standards listed in CMA 001. COST OF LIVING ADJUSTMENT (COLA): Yearly COLA increases are disregarded for QMB clients who would lose eligibility due to the COLA. NOTE: The system automatically disregards these COLA increases. SSI RECIPIENTS: An individual in receipt of SSI, State Supplement payment, or 1916b is not required to have an independent evaluation of income and resources when the recipient requests additional coverage, such as MSP. COVERAGE EFFECTIVE DATE: QMB benefits begin the first of the month after application, provided all eligibility criteria are met. QMB coverage cannot be approved retroactively. SLMB and QI benefits begin the first of the application month and may be approved retroactively for up to three months prior to application/coverage request. ESTATE RECOVERY: Effective January 1, 2010, Medicare premiums paid for through an MSP benefit are not subject to estate recovery.