Page 382

she meets this 30-day test but is in a medical institution solely for the purpose of receiving residential substance use disorder treatment. 27.4.2 Community Spouse See community spouse in Glossary. 27.4.3 SSI Recipient and Institutional Medicaid Application An SSI recipient who has resided or is likely to reside in a medical institution for 30 days or more may apply and be non-financially eligible for institutional Medicaid if the SSA will discontinue the person's SSI because of the financial effect of his or her residence in the medical institution. An SSI recipient who has not resided or is not likely to reside in a medical institution for 30 days or more is non-financially ineligible for institutional Medicaid. The person remains Medicaid eligible through SSI. This page last updated in Release Number: 21-01 Release Date: 03/29/2021 Effective Date: 03/29/2021 27.5 ILTC Financial 27.5.1 ILTC Assets Refer to 16.1 ASSETS INTRODUCTION to determine when an asset is countable. If countable assets exceed the appropriate limit, the Medicaid applicant/member is ineligible. Note: Prepayment to a nursing home for the extra cost of a private room is an available asset. The applicant has the legal ability to make the prepayment available for his or her support and maintenance (16.2 ASSETS AVAILABILITY). 1. Unmarried member - See 39.4 EBD Assets and Income Tables or the EBT asset limits for an unmarried member 2. Married member (Spousal Impoverishment) -The assets of both the institutionalized person and his or her community spouse are counted in the initial asset test. For information about how to determine a married member’s asset limit and the community spouse asset share refer to 18.4 SPOUSAL IMPOVERISHMENT ASSETS. 27.5.2 ILTC Income Follow the policies listed in 15.1 INCOME INTRODUCTION to determine an applicant’s income. The income limit is the same for non-spousal impoverishment institutionalized persons as for spousal impoverishment cases. But, for spousal impoverishment cases, after the institutionalized person becomes eligible, he or she is allowed to allocate some of his or her income back to his or her community spouse (see 18.6 SPOUSAL IMPOVERISHMENT INCOME ALLOCATION) If income is greater than Institutions Categorically Needy Income Limit (39.4 EBD ASSETS AND INCOME TABLES) the person is ineligible for categorically needy Medicaid. If the income is greater than need (see 27.6 ILTC MONTHLY NEED) the person is ineligible for medical needy Medicaid.