Medicaid Policy
Previous Policy (408-1 was previously found in 475-1 until November 1, 2021)
A. The Aged and Disabled 100% Poverty-Related Medicaid
The following policies determine whether to use the 100% poverty rate for one or two persons.
B. Who to Include in the Household Size
The household size for medically needy Medicaid must include the following individuals:
1. Aged or disabled person.
2. Spouse. Note: A spouse is living in the same home if either the individual or the spouse is temporarily absent for schooling, vacation, work, or medical care as defined in 408-2.
a. Aged, blind or disabled spouse.
i. Combine the income of both spouses when both spouses are included in the Medicaid coverage to compare to 100% of the federal poverty level (FPL) for a two-person household.
ii. Deem the income of the spouse if an aged, blind or disabled spouse is not included in the Medicaid coverage, as per deeming policy in Sec. 410-2.
· Use a household size of two even if the spouse has no deemable income.
b. Spouse receives SSI.
· Include an SSI recipient spouse in the household size.
· Count any income other than the SSI payment of the SSI recipient spouse.
· Compare countable income to 100% of poverty for a household size of two.
c. Spouse who is not aged, blind or disabled.
· Deem the income of a spouse living in the same home who is not aged, blind or disabled if that spouse's deemable income is more than the spousal allocation on Table II.
d. Non-qualified non-citizen spouse
· If the spouse is not a qualified non-citizen, deem the income and assets of the non-qualified non-citizen spouse using regular deeming rules.
i. If the non-qualified spouse is aged, blind or disabled, the non-qualified non-citizen will be included in the household size, but cannot be on the Medicaid program (A non-qualified non-citizen can only receive emergency Medicaid services, if he or she meets all other eligibility criteria.).
ii. If there the non-qualified non-citizen spouse has deemable income, include the non-qualified non-citizen spouse in the household size, but do not include the spouse in the medical coverage.
C. Who Not to Include in the Household Size
1. Do not include the sponsor of a non-citizen in the household size.
2. Do not include the spouse who is a resident of a medical institution, or is eligible under a HCB waiver.
3. Do not include the spouse who is living in the same home who is not aged, blind, or disabled if that spouse's deemable income is less than, or equal to, the Spousal Allocation on Table II.