Page 116
UPDATED: JUNE 2010
553
OTHER ELIGIBILITY REQUIREMENTS LEGALLY RESPONSIBLE RELATIVES (LRRs)
SPOUSE
Description: A spouse is an A/R's legal husband or wife. (See definitions in the GLOSSARY) A spouse is a legally responsible relative (LRR). A spouse may be of either sex.
Policy: The spouse of an individual in need of Medicaid, if of sufficient financial ability, is responsible for that person's medical needs. (See RESOURCES THIRD PARTY RESOURCES for utilization of third party health insurance benefits.)
References: SSL Sect. 101
366(3)(a)
Dept. Reg. 360-1.4(h)
360-4.3(f)
360-4.10
360-7.11(b)(ii)
ADMs OMM/ADM 97-2
91 ADM-37
91 ADM-31
90 ADM-29
89 ADM-47
82 ADM-20
82 ADM-6
GISs
08 MA/024
08 MA/023
Interpretation: Spouses Living Together When an A/R is living with his/her spouse, the spouse's income and resources are generally considered available to the A/R (See OTHER ELIGIBILITY REQUIREMENTS HOUSEHOLD COMPOSITION and OWNERSHIP AND AVAILABILITY for budgeting methodologies and availability).
When the spouse asserts that his/her income/resources are not available to the A/R, the eligibility determination depends on whether: (a) the spouse provides financial information; or (b) the spouse refuses to provide the requested financial information. In both instances, at a minimum, a notation is entered into the case record. (See OTHER ELIGIBILITY REQUIREMENTS LEGALLY RESPONSIBLE RELATIVES for general treatment of legally responsible relatives.
(MRG)