No LTC Services Received

<%@LANGUAGE="JAVASCRIPT" CODEPAGE="65001"%> No LTC Services Received

Types of Income Calculations - Beginning and Ending an LTC Income Calculation - Page 2a

No LTC Services Received

When a client did not receive LTC services prior to admittance to an LTCF or receipt of SIS-EW services, begin using an LTC income calculation the month after they were admitted to the LTCF or receipt (or anticipated receipt) of SIS-EW services.

Clara, age 55, is requesting MA and payment of LTC services on February 20. She is requesting one month of retroactive coverage. Clara was admitted to an LTCF on February 15th and is anticipated to stay longer than 30 days. Prior to entering the LTCF she lived with her 17-year-old daughter. She does not have a community spouse.

Use a community income calculation (MA Method FCA – Parent/Caretaker basis) for January, when she was not in the LTCF, and for February, the month Clara was admitted to the LTCF because she does not have a community spouse. Use an LTC income calculation for March, which is the month after her admission to the LTCF.

January	February	March	April	May	June
MA Method FCA Income Calculation	MA Method FCA Income Calculation	LTC Income Calculation	LTC Income Calculation	LTC Income Calculation	LTC Income Calculation

SIS-EW Example:

Elmer, age 67, is an MA enrollee with a certification period of January through June. He requests payment of LTC services through the Elderly Waiver on April 3. His case manager verified on the DHS-5181 that he had a LTCC and that his EW services are anticipated to begin on April 15. He does not have a community spouse and he receives $1,000 of income each month. He is SIS-EW based on his income.

Continue to use the MA Method ABD income calculation (age 65 and over basis) through the month of April. Use an LTC income calculation for May, the month following the month after SIS-EW is scheduled to begin.

January	February	March	April	May	June
MA Method ABD Income Calculation	MA Method ABD Income Calculation	MA Method ABD Income Calculation	MA Method ABD Income Calculation	LTC Income Calculation	LTC Income Calculation

Updated September 15, 2021.
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