Financial Information for HCBS Programs 525-05-25-30

(Revised 5/1/06 ML #3015)

View Archives

1. Spousal Impoverishment

Spousal Impoverishment applies to the Medicaid Waiver programs only. The applicant/recipient must be authorized and receiving a Waiver service on a monthly basis.

Institutional Spouse and Community Spouse (both eligible for Medicaid Waiver Services

If both of the spouses are residing in the home and are screened at nursing facility level of care then spousal impoverishment cannot apply.

1. Income and Medical Deductions:

If institutional spouse resides in a nursing home and the community spouse is in need of services:

• All income is counted for the community spouse which would include the deemed income;
• Medical deductions/prescription drugs counted of community spouse only;
• Household number of one (if no other dependents reside in the home);
• All liquid assets cannot exceed $50,000 for the applicants/clients SPED services, which includes the deemed assets

If institutional spouse resides in the personal home and the applicant client will receive SPED services:

• All household income is counted which would include the deemed income;
• Medical deductions (up to the $700 maximum) prescription drugs are counted for all persons in the household;
• Household number of two (if there are no other dependents residing in the home);
• All liquid assets cannot exceed $50,000 which includes the deemed assets.

When determining spousal impoverishment asset and income limits, see Medicaid Program Service Chapter 510-05. (The amounts change annually.)  

2. Charging for Services

If a client has a recipient liability or SPED service fee, it is the responsibility of the provider to collect the client's share of the cost directly from the client or their identified legal payee.

3. Handling of Collections

County social service boards shall follow the established policies and procedures for the handling of collections in keeping with the acceptable financial management practices and policies of the Department. (See Accounts Receivable Manual, Service Chapter 115-40.)

All fees collected by county social service boards shall be reported on Form 119 according to the instructions for completing the form.

4. Confidentiality of Financial Records

Financial information regarding a client shall remain confidential except where otherwise provided by law or departmental policy. (See Accounts Receivable Manual, Service Chapter 115-40.)