Page 110

Manual Title Chapter Page Revision Date Virginia Medical Assistance Eligibility M03 October 2013 Subchapter Subject Page ending with Page M0320.000 AGED, BLIND & DISABLED GROUPS M0320.701 54

B. ABD MN Covered Groups The ABD MN covered groups are: • M0320.701 ABD • M0320.702 December 1973 Eligibles

M0320.701 ABD MN INDIVIDUALS

A. Legal Base The federal authority for covering ABD MN individuals is found in 42CFR435.330. B. Financial Eligibility

1. Assistance Unit The assistance unit policy and procedures in chapter M05 apply to ABD MN. If married and not institutionalized, deem or count any resources and income from the individual’s spouse with whom he/she lives. If married and institutionalized, go to subchapter M1480 for resource and income determination policy and procedures. 2. Resources All of the individual’s resources must be verified, evaluated, and counted together to determine if the individual meets the Medicaid resource requirements. The resources policy in chapter S11 applies. If current resources are within the limit, go on to determine income eligibility. If the individual is not eligible because of excess real property contiguous to the home, and he/she meets a medically needy Families & Children (F&C) definition, determine if the individual meets an F&C covered group since the F&C home property definition is more liberal for F&C. If the individual is not eligible because of other excess resources, he or she is not eligible as MN.

3. Income Determine gross income according to chapter S08. Subtract the $20 general exclusion and other exclusions. Compare the total countable income to the MN income limit for the individual’s locality group (see section S0810.002) and calculate the MN spenddown amount. See chapter M13 for spenddown policy and procedures. 4. Income Eligibility An individual becomes eligible in this MN covered group when he/she has incurred medical expenses equal to the difference between his/her income and the MN income limit (spenddown).

C. Entitlement Individuals who become eligible after meeting a spenddown are entitled to full Medicaid coverage beginning the day the spenddown was met and ending the last day of the sixth month in the spenddown budget period. Retroactive coverage is applicable to this covered group. Note: Individuals receiving LTC services are placed on monthly spenddowns (see M1460.700).