2509 Couple Budgeting

Georgia State Seal

Georgia Division of Family and Children Services
Medicaid Policy Manual

Policy Title:

Couple Budgeting

Effective Date:

Febuary 2020

Chapter:

2500

Policy Number:

2509

Previous Policy Number(s):

MT 51

Updated or Reviewed in MT:

MT-58

Requirements

Couple budgeting is completed when an individual and his/her spouse residing in LA-A or B both apply for or receive ABD Medicaid as a Medicaid couple.

Basic Considerations

A couple budget is completed for a Medicaid couple residing in LA-A or B whose ABD Medicaid eligibility is determined under the following classes of assistance (COAs):

  • SSI (3 months prior or intervening months)

  • Public Law Classes, including Disabled Widow(er) and Disabled Adult Child (DAC)

  • ABD Medically Needy (AMN)

  • QMB

  • SLMB

  • QI-1

  • QDWI

Procedures

Refer to Section 2503, Couples, for additional information on when to complete a couple budget. Enter the appropriate information in the computer system to allow the system to budget correctly.

OR

Follow the procedures below to complete a manual couple budget on Form 172.

Step 1

Complete Section C of Form 172.

  • Include the income of both spouses of the Medicaid couple in Section C.

  • Allow only one $20 general deduction and one $65 earned income deduction when completing Section C.
Step 2

If there is a deficit on Line 13 of Section C, the Medicaid couple is eligible under this COA based on income.
Step 3

If there is a surplus or zero on Line 13 of Section C, the Medicaid couple is ineligible under this COA. Complete a CMD. Refer to Section 2052, Continuing Medicaid Determination.

If the couple is applying for QMB and there is a zero on Line 13, the individual is eligible for QMB based on income.
If the couple is being budgeted under AMN and there is a surplus on Line 13, use the amount from Line 13 as the AMN spenddown.
If the couple is ineligible for all COAs using Couple budgeting, complete a Spouse to Spouse Deeming budget on each spouse to determine whether one or the other spouse is eligible based on income as a Medicaid individual with an ineligible spouse.
Effective July 1, 2016 the couple income and resource limit for the individual and the individual’s spouse will be used whether or not the spouse is applying (Medicare Eligible) for the QI1 COA.