37.82.407    LIMITATION ON THE FINANCIAL RESPONSIBILITY OF RELATIVES

(1) The income and resources of the following relatives are considered available to an individual in determining the individual's eligibility for Aged Blind Disabled (ABD) Medicaid:

(a) the spouse of the individual, except as provided in (3); and

(b) the biological or adoptive parent or parents or stepparent of the individual with whom the individual resides, if the individual is under the age of 18.

(2) The income and resources of the following relatives are considered available to an individual in determining the individual's eligibility for family Medicaid:

(a) the spouse of the individual, except as provided in (3);

(b) the biological or adoptive parent or parents or stepparent of the individual with whom the individual resides, if the individual is under the age of 19;

(c) for an individual applying for or receiving Medicaid under the child-under age six, child-age six to 19, child-medically needy or family-medically needy coverage groups only, the individual's siblings, half-siblings, or step siblings if the individual chooses to have such siblings included in the filing unit; and

(d) for an individual applying for or receiving Medicaid under any of the coverage groups described in 42 U.S.C. 1396r-6 and 42 U.S.C. 1396u-1, all siblings, half siblings, and step siblings of the individual with whom the individual resides, if the individual is under the age of 19. The individual does not have the option of excluding any such siblings from the filing unit.

(3) The following rules apply In the case of a married individual who is not living with his or her spouse:

(a) In determining the eligibility of an institutionalized spouse as defined in ARM 37.82.1330, resources of the institutionalized spouse's spouse, that is, of the community spouse as defined in ARM 37.82.1330, are considered available to the institutionalized spouse, and a resource assessment must be conducted as provided in ARM 37.82.1331, regardless of whether the institutionalized spouse and the community spouse live together or have ever lived together. In determining the eligibility of an institutionalized spouse the income of the community spouse will be considered as provided in 42 U.S.C. 1396r-5 pertaining to the treatment of income and resources for institutionalized spouses which is adopted and incorporated by reference.

(b) In determining the eligibility of any individual who is not an institutionalized spouse as defined in ARM 37.82.1330, the income and resources of the individual's spouse are considered available to the individual as long as the spouses live together. If the individual and the individual's spouse cease living together, the income and resources of the individual's spouse are not considered available to the individual unless actually contributed to the individual beginning in the first month after the month in which the individual and the individual's spouse ceased living together. If the individual and individual's spouse never lived together, the spouse's income and resources are not considered available to the individual unless actually contributed to the individual.

(4) Except as provided in (1), (2), and (3), the department may not consider the income or resources of any relative to be available to an individual in determining the individual's eligibility for Medicaid unless:

(a) the income or resource are actually contributed to the individual; or

(b) a relative makes a vendor payment on behalf of the individual and the vendor payment would be countable income to the individual as provided in the ABD Medicaid Manual or Family Medicaid Manual that is incorporated by reference in ARM 37.82.101.

 

History: 53-6-113, MCA; IMP, 53-6-113, 53-6-131, MCA; NEW, 1982 MAR p. 729, Eff. 4/16/82; AMD, 1996 MAR p. 284, Eff. 1/26/96; TRANS, from SRS, 2000 MAR p. 476; AMD, 2007 MAR p. 302, Eff. 3/9/07.