Medicaid Policy
Medicaid Policy
Previous Policy (412 was previously found in 411-2 until November 1, 2021)
A. Long-Term Care Household Size
Long-term care programs include people residing in medical institutions, such as nursing homes, and people who qualify under a home and community-based services waiver.
In both cases, the household size consists only of the individual. Do not include a spouse or parent in the household size.
B. Nursing Home Income
1. Married and Single adults – count only the individual's income
2. Child
a. If the child is not disabled and is temporarily absent, count the parents’ income and assets using community Medicaid rules.
b. If the child is not a disabled child and not temporarily absent, count the parents’ income to determine eligibility in the month of entry and the month of discharge from the medical institution. Beginning the month after entry into the medical institution and until the month before discharge, count only the child's income.
c. If the child is disabled, count the parents’ income to determine eligibility in the month of entry and the month of discharge from the medical institution. Beginning the month after entry into the medical institution and until the month before discharge, count only the child's income.
3. Babies born in the hospital who are on an extended stay
a. If SSA or the State Medicaid Disability Office (SMDO) determines the baby is disabled with an onset date during the hospital stay, do not count the parents’ income and assets for the month of birth or for any other month of the institutionalization. Begin counting parents' income and assets the month after the child leaves the hospital.
b. If the baby has not been determined disabled by the SSA or SMDO, count the parents’ income to determine eligibility in the month of entry and the month of discharge into the medical institution. Beginning the month after birth and until the month before discharge, count only the baby's income.
C. Waiver Income
1. Adults
a. New Choices, Community Transitions and Limited Supports Waiver members - Follow the rules found in section 386-2, 384-2 and 388-2 for each income group.
b. All other waivers – Count only the member's income.
2. Children
a. New Choices Waiver members (18-19 year old) - Follow the rules found in 386-2 for each income group.
b. Community Transitions and Limited Supports Wavier members – Follow the rules found in sections 384-2 and 388-2.
c. All other waivers – Count only the member's income.