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West Virginia Income Maintenance Manual Chapter 23

West Virginia Income Maintenance Manual Page 48 Chapter 23 Specific Medicaid Requirements

23.11.5 LONG TERM CARE 23.11.5.A Nursing Facility (Code: MLTN) and Intermediate Care Facility/Individuals with Intellectual Disability (ICF/IID) (Code: MLTI) Income Assets 300% SSI Payment Level $2,000 Individual $3,000 Couple The Department of Human Services (DOHS) provides Medicaid to institutionalized individuals who would not otherwise be eligible for Medicaid if not in an institution. To qualify, an individual must meet the medical criteria for nursing facility or ICF admission, as well as financial criteria. SSI-Related Medicaid disability guidelines also must be met. The determination of which income to count is the same as SSI-Related Medicaid, see Chapter 4. No income is deemed to the client. The client's monthly gross non-excluded income is compared to 300% of the maximum SSI payment for a single individual. The determination of countable assets is the same as for SSI-Related Medicaid, see Chapter 5. The SSI-Related Medicaid asset limit for one person is used. When both spouses are institutionalized and apply for nursing facility services, the SSI-Related Medicaid asset limit for a couple is used to determine eligibility. Details are found in Chapter 24. 23.11.5.B SSI-Related/Monthly Spenddown Group Income Assets MNIL for one person $2,000 Individual An aged, blind or disabled individual residing in a nursing facility may have his eligibility determined as an SSI-Related/Monthly Spenddown Group client as another way to receive financial assistance for the cost of nursing facility services, see Section 24.7. All SSI-Related policies and procedures apply to these cases, including the determination of a spenddown amount, with the following exceptions: