Elizabeth Ribble - Steps 1 and 2

To Do: Read Elizabeth Ribble’s case scenario found on the first page of the Elizabeth Ribble Case Packet. Then complete Sections 1 (Overview questions) and Section 2 (Process Steps 1 and 2) on the following pages of her packet. Return to this page to check your answers.

Question 1.

The begin date for MA-LTC is May 1 based on the case manager indicating EW services will begin on this date on the LTCC. Eligibility for basic MA only will be determined for April.

Question 2.

Yes, an LTC income calculation will be used to determine Elizabeth’s eligibility. Elizabeth’s income is below the Special Income Standard. An LTC income calculation is used for all SIS-EW clients, regardless of whether the client has a community spouse.

Question 3.

No, Elizabeth does not have a community spouse. Sam does not meet the definition of a community spouse because he resides in an LTCF.

Question 4.

The first month an LTC income calculation will be used is for June. Elizabeth requested MA-LTC in April; however the LTCC was not completed until May 1, indicating services will begin on this date. An LTC income calculation begins for a person without a community spouse in the month following the month of scheduled receipt of EW services.

Question 5.

An MA Method B income calculation is used for April and May.

Question 6.

Yes, Elizabeth has a medical spenddown for April.

A Spenddown Worksheet (DHS-1829) has been completed for April (PDF). Remedial care is listed, but comes after M bills, so the expense is not actually used as incurred in the month of the spenddown.

Check your completed Steps 1 and 2 chart against a completed version (PDF).

Page 3

The MA-LTC Medical Expense Deduction - Deduction Process

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