5101:1-39-36 Medicaid: treatment of resources for institutionalized individuals with a spouse in the community.

(A) If the institutionalized spouse (IS) applies for medicaid at any time, the amount of resources that were allocated to the community spouse (CS) as a result of the resource assessment is used to determine the amount of current resources that is allocated to the IS and CS. A resource assessment is completed based upon the beginning of the first continuous period of institutionalization, not the date(s) of application for medicaid. Only one resource assessment is completed per couple regardless of how often an individual has been institutionalized or has applied for medicaid. At the time of application for medicaid a determination of the IS's and CS's current combined resources is computed. The CS is entitled to the amount of resources that were allocated to the CS by the resource assessment.

(B) When an institutionalized spouse applies for medicaid, the CDHS must determine the amount of resources that may be transferred from the institutionalized spouse to the community spouse, in order to determine whether or not the institutionalized spouse is resource eligible and to protect a portion of the resources for the use of the community spouse. Once eligibility is established, the institutionalized spouse shall be given a period of protected medicaid eligibility to give the couple time to complete any necessary resource transfers.

(C) The calculation used to determine the amount of resources that can be transferred includes two key terms: the spousal resource minimum and the spousal resource maximum. The "spousal resource minimum" is the minimum amount of a couple's countable resources allowed for use by the community spouse. The "spousal resource maximum" is the maximum amount of a couple's countable resources allowed for use by the community spouse. Currently, these amounts are as follows:

Effective January 1, 2002

Spousal resource minimum $17,856

Spousal resource maximum $89,280

(D) The budgeting methodology used to determine the institutionalized spouse's resource eligibility is outlined in rule 5101:1-39-36.1 of the Administrative Code.

Eff 1-1-90 (Emer.); 4-1-90; 1-1-91 (Emer.); 4-1-91; 1-1-92 (Emer.); 3-30-92; 2-12-93 (Emer.); 5-13-93; 3-18-94; 9-1-94; 4-1-96; 5-1-97; 4-1-98 (Emer.); 6-1-98; 4-1-99; 1-1-00 (Emer); 4-1-00; 1-1-01; 5-12-02
Rule promulgated under: RC 111.15
Rule authorized by: RC 5111.01 , 5111.011
Rule amplifies: RC 5111.01 , 5111.011
R.C. 119.032 review dates: 3/16/2006