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(c) When the A/R has a dependent family member(s) (See GLOSSARY), deduct a family member allowance for each family member. The family member allowance is deducted for each dependent whether or not the income is actually made available to the family member. The family member allowance is first deducted from any excess income of the community spouse. If the community spouse’s income is insufficient to cover a family member allowance then the remainder is deducted from the income of the institutionalized individual.

(d) Deduct any expenses incurred for health insurance, medical care, services or supplies and/or remedial care for the institutionalized spouse, not paid by Medicaid or a third party. Any remaining available income of the institutionalized spouse and any amount actually contributed from the community spouse is applied to the cost of care on a monthly basis.

A community spouse or family member who is also applying for Medicaid may not refuse to accept his/her monthly income allowance or family member allowance in order to qualify for Medicaid. However, an otherwise eligible community spouse or family member who is under age 21, pregnant, SSI-related or ADC-related and a legally responsible relative of the institutionalized spouse may achieve Medicaid eligibility by contributing any excess income to the cost of the institutionalized spouse's care.

(MRG)