An official State of Texas website.
E-8311 Companion Case Not Contributing Pro-Rata Share
Revision 15-4; Effective December 1, 2015
If a person and the person's ineligible spouse do not contribute their pro-rata share of household expenses, count 1/6 Couple FBR (1/3 Couple FBR divided by 2) as S/M for the person. Do not consider the S/M received by the ineligible spouse (the other 1/6 Couple FBR) in the eligibility determination when deeming.
Example: A couple lives in their daughter's home. The daughter's spouse and their three children also live there. Only one member of the couple is applying for the Qualified Medicare Beneficiary (QMB) program. The couple does not contribute toward household expenses. Count 1/6 Couple FBR (1/3 Couple FBR divided by 2) as S/M. No S/M is considered for the ineligible spouse in the eligibility budget when deeming.
E-8312 Companion Case Contributing Pro-Rata Share
Revision 15-4; Effective December 1, 2015
If a person and the person's ineligible spouse contribute their pro-rata share of either food or shelter expenses but not both, count 1/6 Couple FBR + $10 as S/M for the person. (The S/M attributable to the ineligible spouse is not counted in the eligibility budget when deeming.) If the person is income-eligible, no further development is required. If counting 1/6 Couple FBR + $10 results in ineligibility, the person must be offered an opportunity to rebut and show that the actual value is less.
Example: A couple lives in their son's home. The son's spouse also lives there. Only one member of the couple is applying for QMB. The couple pays more than their pro-rata share of food expenses, but does not pay their pro-rata share of shelter expenses. Count 1/6 Couple FBR + $10 as S/M for the applicant spouse. (Do not consider S/M received by the non-applicant spouse in the eligibility budget when deeming.) If the applicant is income-eligible, no further development is needed.
If counting 1/6 Couple FBR + $10 results in ineligibility, prior to denial, the applicant must be given an opportunity to rebut and show that the actual value is less. The monthly household food expenses total $600 ($150 pro-rata share for one person x 2 = $300 pro-rata share for the couple); the monthly household shelter expenses total $750 ($187.50 pro-rata share for one person x 2 = $375 couple's pro-rata share). The couple contributes $350 ($175 each) for food, but does not contribute toward shelter. The actual value is $162.50 ($300 couple's pro-rata share for food + $375 couple's pro-rata share for shelter = $675 couple's total pro-rata share – $350 couple's contribution = $325 actual value for both spouses divided by 2 = $162.50 actual value for the applicant). Count the maximum S/M of 1/6 Couple FBR + $10 if this amount is less than the actual value. Any S/M received by the non-applicant spouse is not considered in the eligibility budget when deeming.
E-8313 Couple Case Not Contributing Pro-Rata Share
Revision 09-4; Effective December 1, 2009
If neither spouse in a couple case contributes a pro-rata share of household expenses, count 1/3 Couple FBR.
E-8314 Couple Case Contributing Pro-Rata Share
Revision 15-4; Effective December 1, 2015
If both spouses in a couple case contribute their pro-rata share of either food or shelter expenses but not both, count 1/3 Couple FBR + $20. If the couple is income-eligible, no further development is needed. If counting 1/3 Couple FBR + $20 results in ineligibility, prior to denial, the couple must be given an opportunity to rebut and show that the actual value is less.
Example: A couple lives with their daughter in the daughter's home. The couple pays their pro-rata share of food expenses but not shelter expenses. Count 1/3 Couple FBR + $20 as S/M. If couple is income-eligible, no further development is needed. If counting 1/3 Couple FBR + $20 results in ineligibility, prior to denial, the couple must be given an opportunity to rebut and show that the actual value is less. The monthly household food expenses total $350 ($116.66 pro-rata share for one person x 2 people = $233.32 pro-rata share for the couple). The monthly household shelter expenses total $600 ($200 pro-rata share for one person x 2 people = $400 pro-rata share for the couple). The couple contributes $250 ($125 each) for food, but does not contribute toward shelter. In this situation, the actual value is $383.32 ($233.32 couple's pro-rata share for food + $400 couple's pro-rata share for shelter = $633.32 total pro-rata share – $250 couple's contribution = $383.32). Count the maximum S/M of 1/3 Couple FBR + $20 if this is less than the actual value.
E-8320 Ownership or Rental Liability
Revision 09-4; Effective December 1, 2009
E-8321 Couple Case Not Contributing Pro-Rata Share
Revision 15-4; Effective December 1, 2015
If the person and spouse do not pay their pro-rata share of household expenses, count 1/3 Couple FBR + $20. If the couple is income-eligible, no further development is needed. If counting 1/3 Couple FBR + $20 results in ineligibility, prior to denial, the couple must be given an opportunity to rebut and show that the actual value is less.
Example: A couple lives in their own home. Their adult son lives with them. The couple does not contribute their pro-rata share of household expenses. Count 1/3 Couple FBR + $20 as S/M. If the couple is income-eligible, no further development is needed. If counting 1/3 Couple FBR + $20 results in ineligibility, prior to denial, the couple must be given an opportunity to rebut and show that the actual value is less. The monthly household expenses total $750 ($250 pro-rata share for one person x 2 people = $500 pro-rata share for the couple). The son pays the shelter costs of $350 per month. The couple buys all of the food, paying $400 ($200 each) per month. The actual value is $100 ($500 couple's pro-rata share – $400 couple's contribution = $100).
E-8322 Companion Case Not Contributing Pro-Rata Share
Revision 15-4; Effective December 1, 2015
If a person and the person's spouse do not pay their pro-rata share of household expenses, count 1/6 Couple FBR + $10 as S/M for the person. (Do not consider S/M received by the ineligible spouse in the eligibility determination when deeming.) If the person is income-eligible, no further development is needed. If counting 1/6 Couple FBR + $10 results in ineligibility, prior to denial, the person must be given an opportunity to rebut and show that the actual value is less.
Example: A couple lives in their own home. Only one member of the couple is applying for QMB. Two of their adult children live with them. The couple does not pay their pro-rata share of household expenses. Count 1/6 Couple FBR + $10 as S/M for the applicant. (The amount of S/M received by the non-applicant spouse is not considered in determining eligibility when deeming.) If the applicant is income-eligible, no further development is required. If counting 1/6 Couple FBR + $10 results in ineligibility, prior to denial, the applicant must be given an opportunity to rebut and show that the actual value is less. The monthly household expenses total $1,200 ($300 pro-rata share for one person x 2 people = $600 couple's pro-rata share). The children pay the shelter costs of $900 per month, and the couple buys all food, paying $300 ($150 each) per month. The actual value of S/M for the applicant is $150 ($600 couple's pro-rata share – $300 couple's contribution = $300 actual value for both spouses divided by 2 = $150 actual value to the applicant). (The remaining $150 S/M attributed to the non-applicant spouse is not considered in determining eligibility when deeming.) Count the maximum S/M of 1/6 Couple FBR + $10 if this is less than the actual value.
E-8323 Companion Case with Contributions Toward Household Expenses
Revision 15-4; Effective December 1, 2015
If an ineligible spouse's contribution toward household expenses exceeds the ineligible spouse's pro-rata share, then the excess amount is allocated equally as a contribution among the eligible spouse and the couple's children (if any). Persons among whom the ineligible spouse's excess contribution is allocated (for example, the eligible spouse and the couple's children) are referred to as the "deeming unit."
Example: A couple and their 14-year-old child live in a home they are buying. One of the spouse's adult sisters also lives with them. The other spouse is the only one applying for ME-Pickle. The couple pays more than their pro-rata share of food expenses, but does not contribute toward shelter.
Count 1/6 Couple FBR + $10 as S/M for the applicant. (Do not consider S/M received by the non-applicant spouse or the child in the eligibility determination when deeming.)
If the applicant is income-eligible, no further development is required. If counting 1/6 Couple FBR + $10 results in ineligibility, the applicant must be given an opportunity to rebut and show that the actual value is less. The monthly household food expenses total $450 ($112.50 pro-rata share); the monthly household shelter expenses total $600 ($150 pro-rata share). The non-applicant spouse buys all food ($450), but does not contribute toward shelter expenses. The applicant and the child do not personally contribute. The non-applicant spouse's sister pays all remaining household expenses ($600).
The non-applicant's "excess contribution" is $187.50 ($112.50 pro-rata share for food + $150 pro-rata share for shelter = $262.50 total pro-rata share – $450 non-applicant's contribution = -$187.50 excess contribution). The $187.50 is divided equally as a contribution among the applicant and the child in the deeming unit. Thus, $187.50 divided by 2 = $93.75 each as a contribution by the applicant and the child. The actual value of the applicant's S/M is $84.38 ($112.50 pro-rata share for food + $150 pro-rata share for shelter = $262.50 total pro-rata share – $93.75 applicant's contribution = $168.75 actual value of S/M for both spouses divided by 2 = $84.38), which is less than 1/6 Couple FBR + $10.