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HCBS Waiver Eligibility - Income and Resources - Iowa

A waiver recipient is considered to be an "institutionalized" person. The person is treated as an institutionalized person with regard to income, resources, and other eligibility factors. If a waiver recipient goes into a medical institution, it is considered a change in facilities, not a change from noninstitutional to institutional care.

Attribution of Resources:

When the waiver client is married and there is a community spouse, the resource eligibility is determined by the attribution of resources. The date used to determine the attribution is the first of the month that the waiver services will begin and the month that the Iowa Foundation for Medical Care determines that the waiver client meets the appropriate level of care.

If an attribution was completed for a person in a nursing facility and the person switches to waiver, the previously completed attribution is used. A new attribution is not completed.

Treatment of Spouses:

For spouses who are SSI-related and applying for waiver services, income and resources are treated separately when one spouse expects to be in the waiver and the other is a community spouse. The income of the spouse not in the waiver is not counted when determining the waiver spouse’s eligibility and client participation. If the community spouse enters a medical facility, they are treated as a married couple living in separate facilities. When one spouse is in the waiver and the other spouse goes into waiver, policy is applied based on whether the spouse in waiver has been there for six months or less. If the spouse has been in the waiver for six months before the other spouse enters the waiver, the spouse can choose to be treated separately.

If eligibility is determined together, the countable income of both spouses is added together and the total is compared to two times the 300% limit. The countable resources of both spouses are added and the total is compared to the couple resource limit.

See Also:

·           HCBS Waivers Overview

·           Overview of Medical Assistance in Iowa

·           Welcome and Introduction to Benefits in Iowa

Source: Iowa Dept of Human Services Employees Manual

Title 8 Medicaid

·                        Chapter N, page 11

Regulation citations: 441 IAC 83.2(1)"f", 83.22(1)"c", 83.42(1)"c", 83.61(1)"b", 83.82(1)"b", 83.102(1)"e"

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