A divorce dissolves the marriage of a couple and there is no longer spouse-for-spouse responsibility. A legal separation does not dissolve the marriage. The worker shall use the following guidelines in determining financial responsibility for a married couple.
1. Living Together - No Medicaid Waiver Services.
Consider income and resources of both spouses living together in the same household as available to each other. Use the resource standard for two for grant or medical. Budget together for grant or medical, whether one or both are eligible.
Exception: If only one spouse receives SSI and the other spouse receives VA benefits based on need which SSI is disregarding, budget the SSI spouse separately for grant. If the spouse receiving VA is eligible for AABD/MA, budget him/her separately for grant or medical. This only applies if they would be ineligible for SSI as a couple. If they would both be eligible for SSI, the non-SSI spouse must apply (see 469 NAC 2-010.01B6c(1)).
2. Living Together - Medicaid Waiver Services
If both spouses are eligible and one or both receive waiver services, consider income and resources together for grant eligibility. Use the grant resource standard for two and budget together for grant unless the exception under number 1 applies. For medical eligibility, consider income and resources separately. Use the medical resource standard of one for each and budget separately for medical.
If only one spouse is eligible, consider income and resources together for grant eligibility. Use the grant resource standard for two and budget together for grant. The exception in number 1 applies. For medical eligibility, use the spousal impoverishment treatment of resources and income. Refer to 469 NAC 2-009.02C ff. for resources and 469 NAC 4-007.01 for income budgeting on Form DA-4M. An assessment and designation of resources must be completed.
3. Living Apart - Neither in a Specified Living Arrangement
Consider income and resources separately beginning in the first full month the couple cease to live together. Allow the client(s) a resource standard for one for grant or medical and budget the client(s) separately. Total countable resources for the couple must not exceed $8,000. Follow this guideline whether one or both are eligible.
Exception: If either spouse is current pay SSI, follow SSI budgeting rules.
4. Living Apart - Both in a Specified Living Arrangement
If both spouses are in a specified living arrangement, consider income and resources separately. Allow the client(s) a resource standard for one for grant or medical. Budget the client(s) separately for grant or medical. Follow this guideline whether one or both are eligible.
5. Living Apart - One in a Specified Living Arrangement
If only one spouse is eligible, spousal impoverishment rules apply for treatment of income and resources. See 469 NAC 2-009.02C ff. for resources. An assessment and designation of resources must be completed. Budget the client separately for grant and apply the grant resource standard for one. For medical, allow the client the resource standard for one and budget on Form DA-4M (see 469 NAC 4-007.01).
If both spouses are eligible and one enters a specified living arrangement, consider income and resources separately beginning in the first full month the couple cease to live together. Allow each a resource standard for one for grant or medical. Budget separately for grant or medical.
Note: If one spouse is temporarily absent from the home, continue to consider the couple's income and resources together. An absence of less than 90 days may be considered temporary. If the spouse will be absent longer than 90 days, determine if the client plans or is able to return home.