Adult Medicaid Manual MA-2270 LONG TERM CARE NEED AND BUDGETING

IV. DETERMINING ELIGIBILITY FOR The months prior to Long-term care budgeting

A. Individuals Under Age 21

If the institutionalized a/r is under 21, has not been determined disabled or blind (not receiving SSI/SSA or MAD), and is expected to remain institutionalized for over 12 full months, evaluate for long-term care eligibility under Family and Children's coverage groups.(See Family and Children’s Medicaid Manual, MA-3325, Long Term Care Budgeting.)

B. Aged, Blind, or Disabled Adult/Child Who is an Applicant/Recipient

1. For all months prior to the month the CPI begins, the a/r is budgeted PLA and should be budgeted with all persons who are financially responsible for him. (Refer to MA-2260, Financial Eligibility Regulations – PLA.)

2. Effective the month the CPI begins, the budget unit is one.

a. Count only the a/r’s income and determine eligibility under private living arrangement (PLA). Do not count income of the a/r's spouse/parent.

REVISED 11/01/11 – CHANGE NOTICE 17-11

(IV.B.2.)

b. Allow the reserve limit for one, plus the amount of resources protected for the spouse. Refer to MA-2231, Community Spouse Resource Protection.

c. Do not count the pla homesite as a resource for the first month of the CPI because it was the homesite as of the "first moment." Beginning with the second month of the CPI it is no longer excluded as the a/r’s homesite. It is a countable resource unless it can be excluded on another basis (cusp's homesite, intent to return, etc.).