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available to the community spouse, or the community spouse can request a lesser allowance to not affect eligibility in other programs. Follow instructions below:

a. Document the lesser amount, and if possible, obtain a written statement from the a/b, the community spouse, or the representative regarding the reason for the lesser amount, and

b. Deduct the lesser amount when computing the patient monthly liability. 8. The income amount allowed for the community spouse is calculated in two steps:

a. A basic spousal allowance; and

b. Excess shelter costs (see VI.C.)

B. The Basic Spousal Allowance

There is a standard formula used to calculate the basic spousal allowance. Use DHB- 5008, SUPPLEMENT C, as a guide.

1. Verify the community spouse's gross monthly income (including SSI, Special Assistance, or Work First). Do not calculate this allowance until the community spouse's income has been verified.

a. Follow verification procedures in MA-2250, Income.

b. Do not deduct taxes, work-related expenses, or any other deduction or exemption from the community spouse's income.

c. Prorate a Work First grant based on the number of Work First beneficiaries.

2. Basic Allowance for Community Spouse

Compare gross income of the community spouse to the community spouse income standard of $2705.00. (This amount changes yearly in July)

This standard is 150% of the federal poverty limit for 2 people.

a. If the community spouse's gross monthly income equals or exceeds the$2705.00 income standard, STOP. Follow directions in VI.C, below, for consideration of excess shelter costs.

b. If the community spouse's gross monthly income is less than the $2705.00 income standard, determine the basic allowance amount by:

(1) Subtracting the gross income of the community spouse from the$2705.00 income standard.

Docusign Envelope ID: 950E9248-29CC-8930-81BC-BCEC667EB493