Medicaid Policy
Medicaid Policy
Previous Policy (409-3 was previously found in 485-3 until November 1, 2021)
For the Aged, Blind, and Disabled Medically Needy Medicaid, count income from the following individuals:
A. The individual
Count income from the aged, blind, or disabled person.
B. Parents
If the individual is an unemancipated child, count the deemable portion of the income of all parents in the home. (To determine the deemable portion of the income, see 410-3.)
1. Do not deem income from a parent who receives a needs-based VA payment (415-2).
· Deem income only from the other parent, if applicable.
2. Do not count any parental income if any parent in the home receives SSI.
3. Consider a parent to be living in the home with the child even if the child or parent is temporarily absent for school, work, vacation, or medical care.
4. If the individual is a baby born in the hospital who must remain in the hospital for an extended period of time, and disability has been established beginning with the date of birth, consider the child an institutionalized person the month of birth. (To decide when disability begins, see 303-2.) (Follow rules for Nursing Home Medicaid to set up the case 370.)
a. Do not count the parents’ income and assets for the month of birth, or for any other month of the institutionalization.
b. Begin counting parents' income the month after the child leaves the hospital.
c. These children may qualify for SSI.
C. Spouse
1. A spouse will be included in the household size when the spouse is also eligible and wants coverage.
2. A spouse will be counted in the household size when the spouse is not eligible or chooses to not be covered, but has deemable income.
3. Do not count the income of a spouse who is not included in the household size. (See 410-2 for deeming rules.)
4. Do not count income from a spouse who receives SSI or is 1619(b) eligible.
5. Do not count the income of a spouse who is a resident of a medical institution, or who is eligible for nursing home Medicaid.
6. Do not count the income of a spouse who is on a Home and Community Based waiver program for Medicaid programs for the non-waiver spouse.
a. Count cash contributions the nursing home or waiver spouse makes to the community spouse only if the money is actually given to, or made available to, the individual.
b. Contact the nursing home or waiver eligibility case manager to decide the actual contribution amount.
c. If a individual claims he or she is not receiving the amount of a spousal contribution that appears on the spouse's nursing home or waiver case, immediately contact the appropriate eligibility worker with that information.
Note: If the spouse or parents of a individual are not qualified non-citizens, income must still be deemed to the eligible spouse or child using regular deeming rules.