Appendix XXIX, Special Deeming Eligibility Test for Spouse to Spouse
Revision 24-2; Effective June 1, 2024
Note: The following information is effective Jan. 1, 2024.
Step | Spouse-to-Spouse Procedure | Budget | Budget | Budget | ||||
---|---|---|---|---|---|---|---|---|
Pretest | Person must first be eligible based on their own income in the pretest. Determine if the person passes the pretest. Use G-5100, Individual and Couple Noninstitutional Budgets, or G-7000, Prior Coverage, as appropriate. If eligible as an individual in the pretest, use the following steps when deeming from an ineligible spouse to the person. | |||||||
1 | Determine the appropriate income limit. | QMB | SLMB | |||||
2 | Determine the nonexempt and non-excludable gross earned and unearned income of the ineligible spouse. Reference E-1700, Things That Are Not Income, E-2440, Certain Health-Related Payments, E-3170, Census Bureau Wages, E-4300, VA Benefits, E-4318, VA Contracts, E-7200, When Deeming Procedures Are Not Used, and E-7300, When Deeming Procedures Begin. | gross earned | unearned | gross earned | unearned | gross earned | unearned | |
3 | Determine the number of children. | |||||||
If no ineligible children and countable income is less than the program-specific living allowance allocation, skip to 4a. | ||||||||
Program-Specific Living Allowance Allocation: Community MEPD $472, CAS $472, QMB $449, SLMB $538, QI-1 $605, QDWI $897. | ||||||||
Determine the non-exempt income of the ineligible children. Refer to MEPD references in Step 2. | ||||||||
Deduct the program-specific living allowance for each ineligible child reduced by the ineligible child's gross amount of income from the ineligible spouse's countable income. If the child's own income exceeds the allowance, there is no deduction and the child and their income is disregarded in the budget. The living allowance allocations are first deducted from the ineligible spouse's unearned income. If the ineligible spouse does not have enough unearned income to cover the allocation, the balance of the allocation is deducted from the ineligible spouse's earned income. | ||||||||
4a | If remaining income of the ineligible spouse, either unearned or earned, is no more than the program-specific living allowance, stop. No income is deemed. | |||||||
4b | If remaining income of the ineligible spouse, both earned and unearned, exceeds the program-specific living allowance allocation, the person and the ineligible spouse are treated as an eligible couple in the deeming process. Continue with Step 5. | |||||||
5 | Determine person’s monthly gross earned income and monthly unearned income, including the person’s support and maintenance. Because support and maintenance is exempt for the ineligible spouse, use the appropriate companion amount in Appendix XXXI. | gross earned | unearned | gross earned | unearned | gross earned | unearned | |
Combine the remainder of the ineligible spouse's unearned income with the person’s unearned income. Combine the ineligible spouse's earned income with the person’s earned income. | ||||||||
6 | From the combined unearned income, deduct $20. If there is less than $20 unearned income, the remaining portion of the $20 exclusion is applied to earned income. Note: The $20 disregard is not applicable for Special Income Limit cases for Spouse-to-Spouse Deeming (CAS, institutional and Waiver programs). | |||||||
7 | From the combined earned income, deduct up to $65 plus half of the remaining earned income. Note: The earned income exclusion is not applicable for Special Income Limit cases for Spouse-to-Spouse Deeming (CAS, Institutional and Waiver programs). | |||||||
Deduct person’s COLA(s) for Pickle, DAC or Widow or Widowers. | ||||||||
Deduct person’s Social Security COLA for January and February of each year if the current countable income exceeds the appropriate QMB, SLMB or QI-1 Income Limit. | ||||||||
Remainder is countable income. | ||||||||
8 | Compare to the appropriate income limit for an eligible couple. | |||||||
If 1 cent or more unmet need exists, the person is eligible. | ||||||||
For the Special Income Limit or the QMB Limit, if the income is no greater than these limits, the person is eligible. |
Refer to Appendix XXXI for income, resource and budget amounts. If eligible on individual pretest for QMB but not eligible for QMB in the special deeming eligibility test, re-budget for SLMB or QI-1 if applicable. The minimum income requirement for SLMB or QI-1 does not apply when the applicant is ineligible due to deeming.
Related Policy
Support and Maintenance, E-8000
Parent-to-Child Noninstitutional Deeming, G-2312
Twenty-Dollar General Exclusion, G-4110
Earned Income Exclusion, G-4120
Special Income Exclusion for COLA Disregard, G-4300
MSPs and Cost-of-Living Adjustments (COLAs), Q-1400
Budget Reference Chart, Appendix XXXI