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1190 (07/2026) Chapter 8: Examples • Chapter 8: Examples Non-standard living arrangement Example 3: Couple: Both in a community-based care facility, both receiving Medicare John and Sally are married and live in the ACME Foster Home. John is 65, receives Social Security and Medicare. Sally is 60 and has Medicare and Social Security. They both have service needs which meet the service need rule. Their combined income is 119% FPL for a couple. Forming groups: Both John and Sally are in the household group. Note: For MSPs even though they are in a non-standard living situation their income and resources are considered together if they are under the same roof. Standard living arrangement Example 4: Children under 21 in the household Claudia lives with her two minor children, Max and Sarah. She receives a retirement pension and Medicare. Her pension is higher than the one-person QMB standard, but below the three-person standard. Forming groups: All groups (except Benefit) will include Claudia and her children, because she chooses to include them in order to be eligible. Non-standard living arrangement Example 5: Couple: One member in community based care and the other at home, both receiving Medicare and Medicaid. Greg and Sarah are married. Greg lives in the ACME Foster Home while Sarah lives in their home. Greg is 65, receives Social Security and Medicare. Sarah is 60 and has a small pension, Social Security and Medicare. Sarah has no OSIPM eligibility. Greg’s income is 140% FPL and Sarah’s is 130% FPL. Forming groups: There are two sets of groups with Greg and Sarah each having individual household; filing; financial; need and benefit groups for each program. OSIPM Standard living arrangement Example 1: Couple: Adam and Bessie are married and live at home with no services. Both received an SSB increase and are over income for SSI. Both are financially eligible as an individual and adjusted combined income is below the two person OSIPM income standard. Forming groups: Both Adam and Bessie are in the household group. Count both Adam and Bessie’s income (both in Financial group) and use the two-person need standard (both are in the Need group). Both are in the benefit group.