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Manual Title Chapter Page Revision Date Virginia Medical Assistance Eligibility M03 July 2022 Subchapter Subject Page ending with Page M0320.000 AGED, BLIND & DISABLED GROUPS M0320.501 31

M0320.501 ABD IN MEDICAL INSTITUTION, INCOME  300% SSI

LIMIT

A. Policy 42 CFR 435.236 - The state plan includes the covered group of aged, blind or disabled individuals in medical institutions who • meet the Medicaid resource requirements, and • have income that does not exceed 300% of the SSI individual payment limit (see M0810.002 A. 3).

Individuals who are authorized for nursing facility care prior to admittance and are likely to receive the services for 30 days or more consecutive days may also be included in this covered group. B. Financial Eligibility 1. Asset Transfer The individual must meet the asset transfer policy in subchapter M1450. 2. Resources a. Resource Eligibility – Married Individual If the individual is married, use the resource policy in subchapter M1480. Evaluate countable resources using ABD resource policy in chapter S11. If current resources are within the limit, go on to determine income eligibility. If current resources are NOT within the limit, the individual is NOT eligible in this covered group; he may be eligible in an MSP covered group (which has more liberal resource methods and standards). b. Resource Eligibility - Unmarried Individual All of the individual’s resources must be verified, evaluated, and counted together to determine if the individual meets the Medicaid resource requirements. Pay close attention to: 1) equity In non-exempt property contiguous to the individual’s home which exceeds $5,000 and none of the real property exclusions in sections M1130.100, M1130.140, S1130.150, or M1130.160 apply to the property; and 2) ownership of his/her former residence when the individual is in an institution for longer than 6 months. Determine if the former home is excluded in M1130.100 D. If the individual is a blind or disabled child, DO NOT DEEM any resources or income from the child’s parent; count only actual resources the parent makes available to the child. If current resources are within the limit, go on to determine income eligibility.