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West Virginia Income Maintenance Manual Chapter 24

West Virginia Income Maintenance Manual Page 31 Chapter 24 Long Term Care

$2,950 Remainder -$175 OLE $2,775 Remainder -$185 Medicare Part B premium (non-reimbursable medical expense) $2590 Remainder -$2780 Spenddown (non-reimbursable medical expense) 0 Resource Amount The client has no resource amount, so his total contribution is $2,780, his spenddown amount. The DOHS will not pay any part of the $2,780 because it is the client's spenddown and he is, by definition, liable for it. Single Individual without OLE, Medically Needy Example: Same as above except the client has no OLE. The client's spenddown amount is the same as determined above. Post-Eligibility calculations are as follows: $3,000 Income -$50 Personal Needs Allowance $2,950 Remainder -$2,780 Spenddown (non-reimbursable medical expense) $170 Resource Amount The client's total contribution toward his cost of care is: $2,780 Spenddown +$170 Resource Amount $2,950 Total Contribution Married Individual without Community Spouse, Medically Needy Example: Mr. Tulip is married, but has been separated from his wife for 10 years. He has one dependent child still living in his home. His monthly income is $3,000. The monthly Medicaid cost for his care is $4,600. Mr. Tulip is not eligible for the FMA, because there is no community spouse living in his home. Eligibility calculations are as follows: $3,000 Income -$20 SSI Disregard $2,980 Remainder