All Medicaid Programs |
Obsolete Policy |
Allow an income deduction for institutionalized or waiver individuals with dependent family members who are not living in a medical institution. Refer to the specific waiver policy to decide when this deduction can be allowed. This family allowance is deducted from the institutionalized or waiver client's income before deciding how much the client must pay for Medicaid institutional or waiver services.
o Allow this deduction for each dependent family member.
o The term ‘family member’ only includes minor or dependent children, dependent parents, or dependent siblings of the institutionalized or community spouse.
A. When is this Deduction Allowed?
o When the client is in a medical institution or on a HCB waiver, deduct an allowance for dependent family members who are not in a medical institution for a stay that is expected to last more than 30 days and are not eligible for a HCB Medicaid waiver.
1. Contribution to a Family Member
o Deduct an allowance for a dependent family member only to the extent the money will be made available to the family member. The money may go directly to the family member or to a responsible person who will use it for the family member's care.
o Deduct only the amount the client will actually give to or make available to the dependent family member, up to the maximum amount allowed.
o Do not deduct an allowance if the institutional or waiver client says he or she will not give this money to the family member.
2. If the client is married, the deduction begins in the month of entry to a Nursing Home or the first month the client is determined eligible on a Waiver Program.
3. If the client is single, the family deduction begins the month after entry into a Nursing Home. If the client is approved for waiver services, the deduction is allowed the first month of waiver eligibility.
4. When the Deduction Stops
o Stop deducting an allowance the month after the dependent family member no longer meets the criteria for being a dependent family member. For example, the family member's circumstances change so that the client would not be able to claim the family member as a dependent for tax purposes.
o Stop the deduction if the client leaves the Nursing Home or is no longer receiving Waiver Services.
o Stop the deduction the month after the family member enters a medical institution for a stay that lasts, or is expected to last, more than 30 days.
o Stop the deduction from the waiver client's income the month after the family member becomes eligible for a HCB Medicaid waiver.
B. Family Members Who Qualify for a Family Allowance
1. The following family members may qualify for a family allowance:
o A dependent son or daughter of the client or the client's spouse. This includes adoptive and stepchildren. It does not matter if the son or daughter is emancipated.
o Dependent parents of either the client or the spouse including adoptive and stepparents.
o Dependent siblings, step-siblings, half-siblings, and adoptive siblings of the client or the spouse.
2. Who is "Dependent?"
A family member is dependent if he or she is claimed as a dependent of the client or the client's spouse for income tax purposes, or could be claimed if the client or spouse were to file a tax form.
C. Family Member Deduction of a Nursing Home Client
1. When the dependent family member lives with the community spouse, the allowance for a family member is equal to the minimum spousal income maintenance amount minus the family member's income and then divided by 3. Complete this calculation separately for each family member.
2. When the dependent family member does not live with the community spouse, the deduction is equal to the BMS Income Limit for a HH Size of one (Table VII) for each dependent minus their income.
D. Family Member Deduction of a Waiver Client
Not all waiver clients will be eligible to receive this deduction. See the specific waiver policy to determine when to allow this deduction.
For a waiver client, it does not matter whether the dependent lives with the community spouse or not. The allowance for a dependent family member of a waiver eligible client is equal to the minimum spousal income maintenance amount minus the family member's income and then divided by 3. Complete this calculation separately for each family member.