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Manual Title Chapter Page Revision Date Virginia Medical Assistance Eligibility M03 September 2012 Subchapter Subject Page ending with Page M0320.000 AGED, BLIND & DISABLED GROUPS M0320.203 9

living increase(s) (COLAs) received by the spouse (or parent) since the individual lost SSI or AG eligibility is also excluded in determining the protected individual's income eligibility under this section.

2. Resource Eligibility Resource eligibility is determined by comparing the former SSI recipient’s resources to the current Medicaid resource limit. Determine resources using policy in Chapter S11 (including the real property requirements that are more restrictive than SSI). Calculate resources according to the assistance unit policy in chapter M05. 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 protected covered group.

3. Income Eligibility a. Countable Income In figuring income to compare to the current SSI or AG income limit, the income exclusions in chapter S08 are applicable including the $20 exclusion. When the individual meets the above criteria for a protected case and the individual’s assistance unit’s resources are within the Medicaid resource limit: 1) Identify the individual's, and the individual's spouse's (or parent's when applicable), amount of Social Security Title II benefits at the time of SSI termination. If this amount is unknown and cannot be obtained, see item 4. below. 2) When the amount of Social Security Title II benefits at the time of SSI termination is determined: • add the Medicare premium amount to the Title II check amount if only the check amount is known (see item 5. below for Medicare premium amounts); • determine if any change in benefit had occurred between loss of SSI and the point of application. If questionable, multiply the prior Title II amount by the COLA percentages and compare to current entitlement. If the figures are significantly different, use the procedures in 4. below to obtain the amount of Title II at the time SSI was terminated; • if there were no changes, count the Title II amount at the time of SSI loss. Subtract the $20 general exclusion; • count all other current sources of income, apply appropriate exclusions, total countable income. b. Allocation For NBD Child(ren) When determining the amount of a spouse's or parent's deemable income, the allocation for a non blind or disabled (NBD) child(ren) in the home is the same regardless of locality (see M0530, Appendix 1). On the income worksheet, insert the SSI individual payment limit whenever the worksheet calls for the Medicaid income limit.