How to Complete the Title XIX Worksheet (Community Spouse)

Instructions on Completing the MA-12

Spousal Impoverishment Examples – Resources

Resources are determined by adding the total resources that are individually and jointly available to the couple as of the month of the individual’s entry into the nursing facility, regardless of the date of application for Medicaid. For ADvantage and HCBW use the date of application to determine total resources for the couple. The amount […]

Spousal Impoverishment Examples – Income

Income is determined separately for an individual and his/her spouse for ADvantage, Nursing Home Care and Home Community Base Waiver / Intellectually Disabled (HCBW/ID) services. If the Community Spouse (CS’s) monthly gross income is less than the Maximum monthly income standard as shown on Appendix C-1, Schedule XI, the Institutionalized Spouse (IS) may deem a […]

Nursing Facility Services for ABD Related – Determining Income Eligibility

Determining Countable Income If client has been out of their home for 30 consecutive days or longer and is now receiving care in an intermediate care facility (ICF), countable income must be equal to or less than the Categorically Needy Standard (300% of Federal Benefit Rate) found on Appendix C-1 Schedule VIII B.1 beginning the […]