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‘‘(1) ALLOWANCES TO BE OFFSET FROM IN-
COME
OF
INSTITUTIONALIZED
SPOUSE.—After an
institutionalized spouse is determined or redeter-
mined to be eligible for medical assistance, in deter-
mining the amount of the spouse’s income that is to
be applied monthly to payment for the costs of care
in the institution, there shall be deducted from the
spouse’s monthly income the following amounts in
the following order:
‘‘(A) A personal needs allowance (described
in paragraph (2)(A)), in an amount not less
than the amount specified in paragraph (2)(C).
‘‘(B) A community spouse monthly income
allowance (as defined in paragraph (3)), but
only to the extent income of the institutional-
ized spouse is made available to (or for the ben-
efit of) the community spouse.
‘‘(C) A family allowance, for each family
member, equal to at least 1⁄3 of the amount by
which the amount described in paragraph
(4)(A)(i) exceeds the amount of the monthly in-
come of that family member.
‘‘(D) Amounts for incurred expenses for
medical or remedial care for the institutional-
ized spouse as provided under paragraph (6).
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In subparagraph (C), the term ‘family member’ only
includes minor or dependent children, dependent
parents, or dependent siblings of the institutional-
ized or community spouse who are residing with the
community spouse.
‘‘(2) PERSONAL NEEDS ALLOWANCE.—
‘‘(A) IN GENERAL.—The State plan must
provide that, in the case of an institutionalized
individual or couple described in subparagraph
(B), in determining the amount of the individ-
ual’s or couple’s income to be applied monthly
to payment for the cost of care in an institu-
tion, there shall be deducted from the monthly
income (in addition to other allowances other-
wise provided under the plan) a monthly per-
sonal needs allowance—
‘‘(i) which is reasonable in amount for
clothing and other personal needs of the
individual (or couple) while in an institu-
tion, and
‘‘(ii) which is not less (and may be
greater) than the minimum monthly per-
sonal needs allowance described in sub-
paragraph (C).
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‘‘(B) INSTITUTIONALIZED INDIVIDUAL OR
COUPLE
DEFINED.—In this paragraph, the
term ‘institutionalized individual or couple’
means an individual or married couple—
‘‘(i) who is an inpatient (or who are
inpatients) in a medical institution or
nursing facility for which payments are
made under this title throughout a month,
and
‘‘(ii) who is or are determined to be
eligible for medical assistance under the
State plan.
‘‘(C) MINIMUM
ALLOWANCE.—The mini-
mum monthly personal needs allowance de-
scribed in this subparagraph is $40 for an insti-
tutionalized individual and $80 for an institu-
tionalized couple (if both are aged, blind, or dis-
abled, and their incomes are considered avail-
able to each other in determining eligibility).
‘‘(3) COMMUNITY
SPOUSE
MONTHLY
INCOME
ALLOWANCE DEFINED.—
‘‘(A) IN GENERAL.—In this section (except
as provided in subparagraph (B)), the commu-
nity spouse monthly income allowance for a
community spouse is an amount by which—
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‘‘(i) except as provided in subsection
(e), the minimum monthly maintenance
needs allowance (established under and in
accordance with paragraph (4)) for the
spouse, exceeds
‘‘(ii) the amount of monthly income
otherwise available to the community
spouse (determined without regard to such
an allowance).
‘‘(B) COURT
ORDERED
SUPPORT.—If a
court has entered an order against an institu-
tionalized spouse for monthly income for the
support of the community spouse, the commu-
nity spouse monthly income allowance for the
spouse shall be not less than the amount of the
monthly income so ordered.
‘‘(4) ESTABLISHMENT OF MINIMUM MONTHLY
MAINTENANCE NEEDS ALLOWANCE.—
‘‘(A) IN GENERAL.—Each State shall es-
tablish a minimum monthly maintenance needs
allowance for each community spouse which,
subject to subparagraph (B), is equal to or ex-
ceeds—