WAG 15-04-04-a: Community Spouse Maintenance Needs Allowance

PM 15-04-04-a

Refer to Record a Diversion wizard for instructions on entering the spousal maintenance needs allowance income diversion.


NH/SLF cases

  1. Verify income of the community spouse (see PM 08-02-00).
  2. Enter the community spouse and institutionalized spouse's income in IES. Review the IES wizards Complete Income Questions and Record a Diversion for further instructions.
  3. To calculate the Community Spouse Maintenance Needs Allowance (CSMNA), subtract the spouse's gross income from the maintenance needs standard. The difference is the deduction amount.
  4. Allow the maximum amount of the deduction as figured in the IES calculation unless notified by either spouse of a different amount.
  5. The amount of diversion is calculated and displayed on the EDG summary under the group care credit (GCC) tab.
  6. Send the 360C notice of decision.


NOTE: The HFS 2500 form only needs to be sent if the 360C doesn't display the correct group care credit calculation.


new manual materialExample: Mr. A resides in a long term care facility (NH or SLF) and receives an RSDI of $3,500 per month and a pension of $1,250 per month. Total monthly income is $4,750. Mrs. A resides in the community and receives RSDI of $630 per month.

  • For this case, the CSMNA is $3318.00 ($3948.00.- $630). Therefore, $3318.00 is deducted as the CSMNA. The amount of $3318.00 is not available to apply to the cost of long term care if it is given to the community spouse.  $1432.00 (total income minus CSMNA amount) is available to apply to the cost of long term care.


 

Medical cases applying for or receiving services through the DoA HCBS waiver


 Example 1: Mrs. B lives in the community and receives DoA HCBS waiver services. Monthly non-SSI income is $800 per month. Mr. B lives in the community and does not receive DoA HCBS waiver services. Total monthly income is $900 per month.

  • For this case, the Community Spouse Maintenance Needs Allowance (CSMNA) is equal to the maintenance needs standard of Revised text $3948.00 less gross monthly income of the community spouse ( $3948.00 - $900 = $3048). Since this amount is greater than the client's total non-SSI income, enter the amount diverted on Form 2382A. The actual amount of diversion is $800, which is equal to the DoA spouse's income.