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1282 (07/2026) Chapter 8: Examples • Chapter 8: Examples Example 3: Zero CSIA - There is no benefit in transferring the money. George and Ethel are married, on OSIPM, and reside in an assisted living facility. Their service costs are $500.00 each per month. George has $1,200.00 income and Ethel has $950.00 income. George could transfer $1,200.00 - $994.00 = $206.00 LDS to Ethel. If George did this, Ethel’s income would be $950.00 + $206.00 = $1,156.00. Then Ethel’s liability would be $1,156.00 - $994.00 = $162.00. If George and Ethel simply keep their own income and pay their liabilities, all the money, after deducting $994.00 each, is paid to the facility for the cost of services. If George transfers an LDS to Ethel first, the outcome is the same; all the available money after allowing the $994.00 is paid to the facility for the cost of services. The worker allows zero CSIA because transferring the money results in no benefit to the couple. Example 4: Partial CSIA is a benefit for other reasons Leonard is on OSIPM, in a nursing facility and receives $750.00 income per month. Leonard’s spouse Opal is on QMB with $990.00 income. Leonard has $750.00 - $81.28 personal needs = $668.72 available for an CSIA. If that amount is made available to Opal, income received would increase to $990.00 + $668.72 = $1,658.72. Opal would no longer be eligible for QMB, which pays Medicare copays, deductibles and Part B premium. Opal states that these costs exceed $668.72 each month. The worker allows Leonard a partial CSIA deduction of $315.00 so that Opal will continue to be eligible for QMB ($990.00 income + $315.00 CSIA = $1,305). Leonard pays the remaining $353.72 ($750.00 income minus $81.28 PIF and $315.00 CSIA) to the facility for the cost of services. The worker also codes $315.00 of other income diverted from spouse on Opal’s QMB case. OSIPM Medical Costs Example 1: Brenda paid a $50 medical bill on April 28th and provided proof on May 3rd. Approve a $50 medical deduction for the month of April. Example 2: Tyler provided proof of a $100 medical bill incurred in May and is planning on paying it in full in June. The deduction was added for June. In July, Tyler provided a bill from the same provider showing $150 in newly incurred costs along with the original $100 as unpaid. Allow only the new $150 deduction. Example 3: In June, James provides proof of a payment plan for an allowable medical cost. James will be paying $200/month for three months starting July 1st. This amount is more than the liability of $150, but James states the hospital won’t take any less. Code $150/month for three months, July-September.