Pennsylvania Code › Title 55 - HUMAN SERVICES › Part II - Public Assistance Manual › Subpart D - Determination of Need and Amount of Assistance › Chapter 178 - RESOURCE PROVISIONS FOR CATEGORICALLY NMP-MA AND MNO-MA › Subchapter B - AGED, BLIND AND DISABLED CATEGORIES OF MA › RESOURCE ELIGIBILITY REQUIREMENTS FOR AN INSTITUTIONALIZED SPOUSE WITH A COMMUNITY SPOUSE › Section 178.124 - Resource eligibility for the institutionalized spouse

Current through Register Vol. 54, No. 28, July 13, 2024
(a)
Determining initial resource
						eligibility.
(1) The couple's
						countable verified resources are totaled at the time of the MA
						application.
(2) If the spousal
						share determined under §
													178.122 or §
													178.123 (relating to determining
						the spousal share of resources if the institutionalized spouse is not applying
						for MA; and determining the spousal share of resources at the same time the
						institutionalized spouse applies for MA) is equal to, or more than, the
						couple's total countable verified resources at the time of the MA application,
						the institutionalized spouse is resource eligible.
(3) If the spousal share determined under
						§
													178.122 or §
													178.123 is less than the couple's
						total countable resources at the time of the MA application, deduct from the
						couple's countable verified resources at the time of the MA application, the
						greater of the following amounts:
(i) The
						community spouse share, not to exceed the maximum community spouse resource
						standard in 42 U.S.C.A.
						§
															1396r-5(f)(2)(A)
						subject to adjustment under 42 U.S.C.A. §
															1396r-5(g) in years after
						1989 effective January 1 of each year based on the same percentage as the
						percentage increase in the Consumer Price Index (CPI) for all urban
						consumers-all items, United States city average-between the period of September
						to September of the previous year. Revisions required by Federal law and
						regulations to the amount will be published as a notice in the
Pennsylvania Bulletin
and will be made available upon request
						at the CAOs.
(ii) The standard
						community spouse resource standard in
						42 U.S.C.A. §
															1396r-5(f)(2)(A)(i)
						subject to adjustment under 42 U.S.C.A. §
															1396r-5(g) in the years
						after 1989 effective January 1 of each year based on the same percentage as the
						percentage increase in the CPI for all urban consumers-all items, United States
						city average-between the period of September to September of the previous year.
						Revisions required by Federal law and regulations to the amounts will be
						published as a notice in the
Pennsylvania Bulletin
and will be
						made available upon request at the CAOs.
(iii) The amount of the resources in excess
						of the maximum community spouse resource standard transferred by the
						institutionalized spouse to the community spouse under a court support order.
						The fair consideration requirements at
						42 U.S.C.A.
						1396p do not apply to amounts of resources
						transferred under an order of support.
(iv) The amount designated by a Departmental
						hearing decision.
(4)
						Compare the remaining resources to the one person resource limit in Appendix A
						for the appropriate MA program.
(5)
						If the remaining resources are equal to, or less than, the appropriate MA
						resource limit in Appendix A for the appropriate MA program, the
						institutionalized spouse is resource eligible.
(6) The institutionalized spouse is not
						ineligible for MA on the basis of excess resources if the CAO determines that
						the denial of MA would cause undue hardship as defined in §
													178.2 (relating to
						definitions).