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To determine eligibility, the value of counted resources owned by each member of the customer’s resource group is totaled and compared to the resource limit.
Resource Group Members
The following chart shows who is in the customer’s resource group:
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If the customer is... |
And... |
And... |
Then the Resource Group includes... |
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Unmarried child <18 |
Lives with parents |
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Customer |
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Refuses HCBS services |
Customer and parents |
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Does not live with parents |
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Customer |
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Married |
Has a community spouse |
During the Initial Period |
Customer and spouse |
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During Post-Initial Period |
Customer |
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Has a non-community spouse |
Living together at home or in an HCBS residential setting |
Customer |
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The spouse is in a medical institution |
Customer |
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Living together in an alternative residential setting in which ALTCS services cannot be provided |
Customer and spouse |
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Customer refuses HCBS |
Customer and spouse |
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Does not live with non-community spouse |
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Customer |
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Unmarried Adult |
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Customer |
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Term |
Definition |
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Resource Group |
The people whose resources are considered available to the customer, and may be counted when determining the customer’s total resources. |
Proof of Resources
If needed, the customer must provide proof of resources for everyone in the budget group. See MA705 for details about the proof needed for each type of resource.
Proof of Marriage
The customer must provide proof of legal marriage for eligibility to be determined using community spouse policy. See MA520 - Legal Marriage for the type of proof needed for marriage.
Proof of Parent/Child Relationship
Proof of family relationships and who lives in the household is needed only when there is information that conflicts with the customer’s statement.
A customer’s statement includes information provided by the customer on a signed application.
Some items that show proof of relationship between a parent and child are:
The child’s birth certificate or other birth record;
Court records; and
Religious records.
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Program |
Legal Authorities |
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ALTCS |
42 USC 1396a(a)(10)(A)(ii) (V) 42 USC 1396r-5 for Community Spouse AAC R9-28-407 and 410 |