IM-10 01/29/93 ELIGIBILITY FOR MEDICAID
FOR PERSONS WHO RECEIVE
HOME AND COMMUNITY BASED WAIVER SERVICES
REVISION AND CLARIFICATION OF IM-#117 (1992)
|ELIGIBILITY FOR MEDICAID FOR PERSONS WHO RECEIVE HOME AND COMMUNITY BASED WAIVER SERVICES -- REVISION AND CLARIFICATION OF IM-#117 (1992)|
|The purpose of this memorandum is to make
a revision and clarify information in IM-#117 (1992) regarding Medicaid
eligibility under Home and Community Based (HCB) Waiver criteria.
On page 3 of IM-#117, we stated, "If both members of the couple are determined by DA to require both an NF level of care and HCB waiver services, the couple is not eligible for an assessment of assets or Title XIX using HCB waiver criteria."
It is correct that such a couple may not receive an assessment and division of assets, because both members of the couple meet the definition of institutionalized. If the couple meets the regular resource standard ($2,000), however, the HCB waiver income criteria ($750) may be applied in determining Medicaid eligibility for each member of the couple.
Both Mr. and Mrs. Hickby are authorized by DA for HCB waiver services. They do not qualify for division of assets, but their combined resources are $1,500, which is less than the resource maximum. Mr. Hickby's gross income of $654.80 allows him to qualify for Medicaid under the HCB waiver criteria, and Mrs. Hickby's gross income of $559.80 allows her to qualify for Medicaid under the HCB waiver criteria.
Following are common questions we have received regarding HCB waiver criteria Medicaid eligibility and responses.
When we developed the HCB fact sheet, it was to help the home care industry understand HCB waiver eligibility criteria. We equated the term "HCB Spouse" with "Institutionalized Spouse", as it is used for division of assets. This terminology was familiar to the industry, because one of it's main interests was to implement spousal impoverishment rules for HCB recipients.THANK YOU
As we stated in IM-#117 (1992), it is very
important to quickly convert Social Services
We also appreciate you cooperation with Division of Aging staff, and you prompt action in dealing with cases they refer to you.