Although each spouse’s income is considered separately when determining financial eligibility for long-term care, there’s no provision in SSP policy to allow the Community Spouse to become eligibile for SSP when the couple’s combined income is over the ABD couple standard. When one or both is approved for ADvantage or other HCBW all income is available to both spouses. It is incorrect to approve, increase or decrease the amount of SSP the couple receives when one or both are approved for ADvantage or other HCBW. Eligibility for SSP, and the amount received, is based on the couple’s income, not the individual.
When the combined income entitles the couple to SSP and one or both spouses are approved for ADvantage or other HCBW, marital status must be coded ML (married living together). The cases must be coded as a companion cases for the computer to determine the proper amount of SSP.
When the combined income exceeds the ABD couples standard, the marital status must be coded as MP (married involuntarily separated).
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