820
nance charge, for the community spouse’s prin-
cipal residence, and
‘‘(B) the standard utility allowance (used
by the State under section 5(e) of the Food
Stamp Act of 1977) or, if the State does not
use such an allowance, the spouse’s actual util-
ity expenses,
exceeds 30 percent of the amount described in para-
graph (4)(A)(i), except that, in the case of a con-
dominium or cooperative, for which a maintenance
charge is included under subparagraph (A), any al-
lowance under subparagraph (B) shall be reduced to
the extent the maintenance charge includes utility
expenses.
‘‘(6) TREATMENT OF INCURRED EXPENSES.—
With respect to the post-eligibility treatment of in-
come under this section, there shall be disregarded
reparation payments made by the Federal Republic
of Germany and, there shall be taken into account
amounts for incurred expenses for medical or reme-
dial care that are not subject to payment by a third
party, including—
‘‘(A) medicare and other health insurance
premiums, deductibles, or coinsurance, and
821
‘‘(B) necessary medical or remedial care
recognized under State law but not covered
under the State plan under this title, subject to
reasonable limits the State may establish on the
amount of these expenses.
‘‘(e) NOTICE AND FAIR HEARING.—
‘‘(1) NOTICE.—Upon—
‘‘(A) a determination of eligibility for med-
ical assistance of an institutionalized spouse, or
‘‘(B) a request by either the institutional-
ized spouse, or the community spouse, or a rep-
resentative acting on behalf of either spouse,
each State shall notify both spouses (in the case de-
scribed in subparagraph (A)) or the spouse making
the request (in the case described in subparagraph
(B)) of the amount of the community spouse month-
ly 
income 
allowance 
(described 
in 
subsection
(d)(1)(B)), of the amount of any family allowances
(described in subsection (d)(1)(C)), of the method
for computing the amount of the community spouse
resources allowance permitted under subsection (f),
and of the spouse’s right to a fair hearing under the
State plan respecting ownership or availability of in-
come or resources, and the determination of the
822
community spouse monthly income or resource al-
lowance.
‘‘(2) FAIR HEARING.—
‘‘(A) IN GENERAL.—If either the institu-
tionalized spouse or the community spouse is
dissatisfied with a determination of—
‘‘(i) the community spouse monthly
income allowance;
‘‘(ii) the amount of monthly income
otherwise available to the community
spouse 
(as 
applied 
under 
subsection
(d)(3)(A)(ii));
‘‘(iii) the computation of the spousal
share of resources under subsection (c)(1);
‘‘(iv) the attribution of resources
under subsection (c)(2); or
‘‘(v) the determination of the commu-
nity spouse resource allowance (as defined
in subsection (f)(2));
such spouse is entitled to a fair hearing under
the State plan with respect to such determina-
tion if an application for benefits under this
title has been made on behalf of the institu-
tionalized spouse. Any such hearing respecting
the determination of the community spouse re-
823
source allowance shall be held within 30 days of
the date of the request for the hearing.
‘‘(B) REVISION
OF
MINIMUM
MONTHLY
MAINTENANCE
NEEDS
ALLOWANCE.—If either
such spouse establishes that the community
spouse needs income, above the level otherwise
provided by the minimum monthly maintenance
needs 
allowance, 
due 
to 
exceptional 
cir-
cumstances resulting in significant financial du-
ress, there shall be substituted, for the mini-
mum monthly maintenance needs allowance in
subsection (d)(3)(A)(i), an amount adequate to
provide such additional income as is necessary.
‘‘(C) REVISION
OF
COMMUNITY
SPOUSE
RESOURCE ALLOWANCE.—If either such spouse
establishes that the community spouse resource
allowance (in relation to the amount of income
generated by such an allowance) is inadequate
to raise the community spouse’s income to the
minimum monthly maintenance needs allow-
ance, there shall be substituted, for the commu-
nity spouse resource allowance under subsection
(f)(2), an amount adequate to provide such a
minimum monthly maintenance needs allow-
ance.
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‘‘(f) PERMITTING TRANSFER
OF RESOURCES
TO
COMMUNITY SPOUSE.—
‘‘(1) IN GENERAL.—An institutionalized spouse
may, without regard to any other provision of the
State plan to the contrary, transfer an amount equal
to the community spouse resource allowance (as de-
fined in paragraph (2)), but only to the extent the
resources of the institutionalized spouse are trans-
ferred to, or for the sole benefit of, the community
spouse. The transfer under the preceding sentence
shall be made as soon as practicable after the date
of the initial determination of eligibility, taking into
account such time as may be necessary to obtain a
court order under paragraph (3).
‘‘(2) COMMUNITY
SPOUSE
RESOURCE
ALLOW-
ANCE DEFINED.—In paragraph (1), the ‘community
spouse resource allowance’ for a community spouse
is an amount (if any) by which—
‘‘(A) the greatest of—
‘‘(i) $12,000 (subject to adjustment
under subsection (g)), or, if greater (but
not to exceed the amount specified in
clause (ii)(II)) an amount specified under
the State plan,