Medicaid for the Elderly and People with Disabilities Handbook

Revision 09-4; Effective December 1, 2009

When the living arrangement is noninstitutional, income from support and maintenance and from deeming are considered in the eligibility budget. Refer to information in:

• E-8000, Support and Maintenance
• E-7000, Deeming Income

G-2310 Noninstitutional Deeming

Revision 09-4; Effective December 1, 2009

The term "deeming" identifies the process of considering another person's income and resources to determine available funds for meeting a person's basic needs of food and shelter.

G-2311 Spouse-to-Spouse Noninstitutional Deeming

Revision 09-4; Effective December 1, 2009

Use the following steps to prepare a budget for an individual when the person lives with an ineligible spouse in a non-institutional living arrangement.

G-2311.1 Pretest to Deeming

Revision 11-4; Effective December 1, 2011

For spouse-to-spouse deeming policy to apply, the person must first be eligible based on the person's own income in the pretest. To determine if the person meets the pretest, use the steps in G-5000, Noninstitutional Budget Steps, to determine the person's countable income and compare the person's countable income to the program's income limit for an individual.

If the individual is eligible in the pretest, Appendix XXIX, Special Deeming Eligibility Test for Spouse to Spouse, provides the manual steps used to calculate eligibility with deeming.

• Allocations — An allocation is an amount deducted from income that is subject to deeming, which is considered to be set aside for the support of certain individuals other than the eligible individual. Normally, the allocation amounts are based on the difference between the eligible couple and individual income limits for the program being tested.
  
  Example: The allocation for a Medicaid program that uses the SSI federal benefit rate (FBR) limit is the difference between the SSI FBR couple and SSI FBR individual income limits. See Appendix XXXI, Budget Reference Chart.
• The allocation for Qualified Medicare Beneficiaries (QMB) is the difference between the QMB couple and QMB individual income limits.
• The allocation amount when the Special Income Limit is used is the difference between the SSI FBR couple and SSI FBR individual income limits.
• When the Special Income Limit is used, the general income exclusion and the earned income exclusion are not allowed.

G-2311.2 Examples of Spouse-to-Spouse Deeming

Revision 25-1; Effective March 1, 2025

A couple lives together in their own home. Only one spouse is applying for Community Attendant Services (CAS). The applicant’s only income is gross monthly Retirement, Survivors, and Disability Insurance (RSDI) benefits of $675. The non-applicant spouse is working and earns $800 gross monthly wages. The non-applicant spouse also gets RSDI of $200, and their 16-year-old son gets RSDI of $211.

Deeming Pretest — Person must be eligible as an individual first.

Applicant's income:

Remainder is less than the individual income limit for CAS. Continue with the deeming process.

Determining the ineligible spouse's income. Refer to this section and Appendix XXIX, Special Deeming Eligibility Test for Spouse to Spouse:

A couple lives together in their own home. Only one spouse is applying for QMB. The applicant's only income is gross monthly RSDI of $780. The non-applicant spouse's gross monthly wages are $800. They have no children.

Deeming Pretest — Person must be eligible as an individual first.

Remainder is less than the individual income limit for QMB. Continue with the deeming process.

Determining the ineligible spouse's income. Refer to this section and Appendix XXIX, Special Deeming Eligibility Test for Spouse to Spouse.

G-2312 Parent-to-Child Noninstitutional Deeming

Revision 11-3; Effective September 1, 2011

The term deeming identifies the process of considering another person's income and resources to be available for meeting a person's basic needs of food and shelter.

Allocations — To consider that a portion of an ineligible parent's income is used to provide for the ineligible parent's own living expenses and those of any ineligible child/children living in the household. Based on this consideration, apply allocations for:

• ineligible parents; and
• ineligible children in the household.

Application of these allocations reduces the amount of income available for deeming.

Deem a parent's income to an eligible child beginning the month:

• after the month the child comes home to live with the parent(s) (for example, the month following the month the child comes home from the hospital); or
• of birth when a child is born in the parent's home; or
• after the month of adoption (the month of adoption is the month the adoption becomes final); or
• after the month of marriage (for example, when a natural or adoptive parent marries) or the month after the month a parent begins living in a relationship in which they hold themselves out as married.

Deeming applies from a parent to a child when they live together in the same household.

Exceptions:

An ineligible spouse or parent who is absent from a deeming household due solely to a duty assignment as a member of the Armed Forces on active duty will, in the absence of evidence to the contrary, be considered to be living in the same household as the Supplemental Security Income (SSI) claimant/recipient for income and resources deeming purposes.

This policy applies regardless of how long the deemor is absent from the household due to a duty assignment and regardless of when such absence began.

If a natural or adoptive parent is deceased or is divorced from the stepparent, and the child is living with the stepparent, the stepparent is not considered a parent or spouse of a parent of the eligible child for deeming purposes.

Deeming does not apply if one or both of the parents are eligible for Medicaid.

This deeming process does not apply to the Medicaid Buy-In for Children (MBIC) program. See N-6000, Budgeting, for consideration of parents' income in the eligibility budget for MBIC.

To determine the amount of a parent's (and the parent's spouse's, if any) income to be deemed to a disabled child under 18, use the following steps.

G-2312.1 Examples of Parent-to-Child Deeming

Revision 25-1; Effective March 1, 2025

Example 1:

A child is 14 years old and is applying for Prior Medical for Supplemental Security Income (SSI) (ME-SSI Prior). He lives with his ineligible parents. He has one ineligible 16-year-old sibling. Neither child has any income. The parents' gross monthly earnings total $1,500, and their gross unearned income is $100.

Parent-to-Child Deeming

Determining the Applicant's Income

Example 2:

A child is 13 years old and is applying for Community Attendant Services (CAS). She lives with her ineligible parents. She has two ineligible brothers, 15 and 16 years old. She gets $700 per month in RSDI disability benefits. Her brothers have no income. The parents' gross monthly earned income is $2,000, and their gross monthly unearned income is $200.

Parent-to-Child Deeming

When parent-to-child deeming occurs for CAS, the $20 and the $65 plus one-half earnings exclusions are deducted from the parents’ countable income to calculate the income deemed to the child. CAS does not allow these exclusions for the child who is the applicant or recipient.

Determining the Applicant's Income