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Apply each state's rule for a Medicaid applicant whose spouse is not aged, blind or disabled #10640

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Apply each state's rule for a Medicaid applicant whose spouse is not aged, blind or disabled #10640

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b0f008d
Apply each state's rule for a Medicaid applicant whose spouse is not …
hua7450 Nov 2, 2026
f157134
Merge remote-tracking branch 'upstream/main' into medicaid-couple-lim…
hua7450 Nov 2, 2026
d76697c
Cite the project lead's rulings in the source-conflict candidates
hua7450 Nov 2, 2026
ca5bd31
Fix facility splits and budget-together income in the couple standard
hua7450 Nov 3, 2026
14b1920
Merge remote-tracking branch 'upstream/main' into medicaid-couple-lim…
hua7450 Nov 3, 2026
37d23c8
Test Hawaii's medically needy couple setting
hua7450 Nov 3, 2026
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1 change: 1 addition & 0 deletions changelog.d/medicaid-couple-limit-ineligible-spouse.fixed.md
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Apply each state's own rule for a Medicaid applicant whose spouse is not aged, blind or disabled, in the aged, blind and disabled pathway, the 209(b) route and medically needy: SSI's deeming rule by default, or budgeting the couple together, or keeping the couple limit without deeming. Test spouses split by a facility separately, with no spouse income counted.
142 changes: 142 additions & 0 deletions ...medicaid/eligibility/categories/medically_needy/limit/income/budgets_couple_together.yaml
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description: States count a spouse's income and test a married couple living together against the couple limit, whether or not SSI deeming would apply, under the Medicaid medically needy program, if this is true.
metadata:
unit: bool
period: year
label: Medicaid medically needy couple budgeted together
breakdown:
- state_code
reference:
- title: 42 CFR 435.601 - Application of financial eligibility methodologies
href: https://www.law.cornell.edu/cfr/text/42/435.601
- title: "Arkansas Medical Services Policy Manual O-531 #page 424-425"
href: https://humanservices.arkansas.gov/wp-content/uploads/MS-Policy-9.26-New.pdf#page=424
- title: 22 CCR 50373 (California)
href: https://www.law.cornell.edu/regulations/california/22-CCR-50373
- title: Connecticut Uniform Policy Manual 5020.75
href: https://portal.ct.gov/-/media/Departments-and-Agencies/DSS/UPMs/UPM5---Treatment-of-Income-Income-Eligibility/5020_75.doc
- title: HAR 17-1724.1-16(1) (Hawaii)
href: https://humanservices.hawaii.gov/wp-content/uploads/2016/12/HAR-17-1724.1-INCOME-FOR-MAGI-EXCEPTED-Final-10-31-16-1.pdf#page=5
- title: Illinois Policy Manual PM 15-06-02-c
href: https://www.dhs.state.il.us/page.aspx?item=16512
- title: Kansas MKEESM 4312
href: https://khap.kdhe.ks.gov/KEESM/July_2026_Output/4000/4310-Assistance-Planning.htm
- title: 130 CMR 520.002(A)(1) (Massachusetts)
href: https://web.archive.org/web/20260711022327id_/https://www.mass.gov/doc/130-cmr-520000-masshealth-financial-eligibility-0/download#page=2
- title: "Maryland Medical Assistance Manual Section 600 #page 7-8"
href: https://health.maryland.gov/mmcp/Medicaid%20Manual/Section%20600-%20The%20Assistance%20Unit.pdf#page=7
- title: Michigan BEM 211 - Fiscal and asset group for SSI-related groups
href: https://dhhs.michigan.gov/olmweb/ex/BP/Public/BEM/211.pdf#page=8
- title: Minnesota Eligibility Policy Manual 2.3.3.3.2.1.1 - Income deeming
href: https://hcopub.dhs.state.mn.us/epm/2_3_3_3_2_1_1.htm
- title: N.D. Admin. Code 75-02-02.1-34 (North Dakota)
href: https://ndlegis.gov/information/acdata/pdf/75-02-02.1.pdf#page=70
- title: 477 NAC 25-002 (Nebraska)
href: https://www.law.cornell.edu/regulations/nebraska/477-Neb-Admin-Code-ch-25-SS-002
- title: N.H. Code Admin. R. He-W 858.04
href: https://www.law.cornell.edu/regulations/new-hampshire/N-H-Admin-Code-SS-He-W-858.04
- title: "Vermont Health Benefits Eligibility and Enrollment Rule, Part 5, 29.04 and 29.14 #page 14,52"
href: https://humanservices.vermont.gov/sites/ahsnew/files/documents/HBEE-Part-5-Financial-Methodologies.pdf#page=14
- title: Wisconsin Medicaid Eligibility Handbook 15.1
href: https://www.emhandbooks.wisconsin.gov/meh-ebd/policy_files/15/15.1.htm
AK:
2015-01-01: false
AL:
2015-01-01: false
AR:
2015-01-01: true
AZ:
2015-01-01: false
CA:
2015-01-01: true
CO:
2015-01-01: false
CT:
2015-01-01: true
DC:
2015-01-01: false
DE:
2015-01-01: false
FL:
2015-01-01: false
GA:
2015-01-01: false
HI:
2015-01-01: true
IA:
2015-01-01: false
ID:
2015-01-01: false
IL:
2015-01-01: true
IN:
2015-01-01: false
KS:
2015-01-01: true
KY:
2015-01-01: false
LA:
2015-01-01: false
MA:
2015-01-01: true
MD:
2015-01-01: true
ME:
2015-01-01: false
MI:
2015-01-01: true
MN:
2015-01-01: true
MO:
2015-01-01: false
MS:
2015-01-01: false
MT:
2015-01-01: false
NC:
2015-01-01: false
ND:
2015-01-01: true
NE:
2015-01-01: true
NH:
2015-01-01: true
NJ:
2015-01-01: false
NM:
2015-01-01: false
NV:
2015-01-01: false
NY:
2015-01-01: false
OH:
2015-01-01: false
OK:
2015-01-01: false
OR:
2015-01-01: false
PA:
2015-01-01: false
RI:
2015-01-01: false
SC:
2015-01-01: false
SD:
2015-01-01: false
TN:
2015-01-01: false
TX:
2015-01-01: false
UT:
2015-01-01: false
VA:
2015-01-01: false
VT:
2015-01-01: true
WA:
2015-01-01: false
WI:
2015-01-01: true
WV:
2015-01-01: false
WY:
2015-01-01: false
114 changes: 114 additions & 0 deletions ...aid/eligibility/categories/medically_needy/limit/income/couple_limit_without_deeming.yaml
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description: States test an applicant against the couple limit even when no income is deemed from a spouse who is not aged, blind, or disabled, under the Medicaid medically needy program, if this is true.
metadata:
unit: bool
period: year
label: Medicaid medically needy couple limit applies without deeming
breakdown:
- state_code
reference:
- title: N.J.A.C. 10:70-3.5(c)2
href: https://www.law.cornell.edu/regulations/new-jersey/N-J-A-C-10-70-3-5
- title: 210-RICR-40-05-2 (Rhode Island)
href: https://rules.sos.ri.gov/regulations/part/210-40-05-2
AK:
2015-01-01: false
AL:
2015-01-01: false
AR:
2015-01-01: false
AZ:
2015-01-01: false
CA:
2015-01-01: false
CO:
2015-01-01: false
CT:
2015-01-01: false
DC:
2015-01-01: false
DE:
2015-01-01: false
FL:
2015-01-01: false
GA:
2015-01-01: false
HI:
2015-01-01: false
IA:
2015-01-01: false
ID:
2015-01-01: false
IL:
2015-01-01: false
IN:
2015-01-01: false
KS:
2015-01-01: false
KY:
2015-01-01: false
LA:
2015-01-01: false
MA:
2015-01-01: false
MD:
2015-01-01: false
ME:
2015-01-01: false
MI:
2015-01-01: false
MN:
2015-01-01: false
MO:
2015-01-01: false
MS:
2015-01-01: false
MT:
2015-01-01: false
NC:
2015-01-01: false
ND:
2015-01-01: false
NE:
2015-01-01: false
NH:
2015-01-01: false
NJ:
2015-01-01: true
NM:
2015-01-01: false
NV:
2015-01-01: false
NY:
2015-01-01: false
OH:
2015-01-01: false
OK:
2015-01-01: false
OR:
2015-01-01: false
PA:
2015-01-01: false
RI:
2015-01-01: true
SC:
2015-01-01: false
SD:
2015-01-01: false
TN:
2015-01-01: false
TX:
2015-01-01: false
UT:
2015-01-01: false
VA:
2015-01-01: false
VT:
2015-01-01: false
WA:
2015-01-01: false
WI:
2015-01-01: false
WV:
2015-01-01: false
WY:
2015-01-01: false
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