Md. Code Regs. 10.09.41.04

Current through Register Vol. 51, No. 22, November 1, 2024

Section 10.09.41.04 - Financial Eligibility

A. Assistance Unit. An applicant's or recipient's assistance unit shall include the:

(1) Applicant or recipient; and

(2) Applicant's or recipient's spouse when living in the same household, whether or not the spouse is eligible for the same benefits under this chapter.

B. Consideration of Income.

(1) Except as provided in §B(2) or C of this regulation, the Department shall determine, in accordance with the policies and procedures for aged, blind, or disabled coverage groups specified at COMAR 10.09.24, the countable net income of an EID applicant or participant for purposes of determining the applicable premium amount under Regulation .07 of this chapter.

(2) To determine the countable net income of an EID assistance unit, the Department shall subtract from the assistance unit's total gross income:

(a) The general income exclusions and disregards and the specific income exclusions and disregards for aged, blind, or disabled coverage groups specified at COMAR 10.09.24; and

(b) An amount equal to the applicant's, recipient's, or spouse's documented out-of-pocket cost of premium payments to secure current employer-sponsored insurance coverage that includes coverage of the applicant or recipient.

(3) As a condition of eligibility for Medical Assistance benefits under this chapter, unless good cause for not doing so is shown, applicants and recipients, shall take all necessary steps to obtain any annuities, pensions, retirement, and disability benefits to which they are entitled, including, but not limited to:

(a) Veterans' compensation and pensions;

(b) Old Age and Survivors' Disability Insurance (OASDI) benefits;

(c) Railroad retirement benefits;

(d) Unemployment compensation; or

(e) Social Security Disability Income (SSDI).

(4) Income Standards. Effective January 1, 2024, no income standard applies to applicants or participant under this chapter.

C. Consideration of Resources.

(1) Except as provided in this section, whether an applicant meets the resource standards for eligibility for the EID coverage group shall be determined according to the policies and procedures for aged, blind, or disabled coverage groups specified in COMAR 10.09.24.

(2) To determine the total countable resources of an applicant, the Department shall apply the general resource exclusions and specific resource exclusions for aged, blind, or disabled coverage groups specified in COMAR 10.09.24 to the total gross resources of the applicant.

(3) From the total countable resources of the applicant determined pursuant to §C(1) and (2) of this regulation, the Department shall subtract the aggregate current cash value of the applicant's or participant's ownership interest in any of the following types of accounts:

(a) 401(k) retirement account;

(b) 403(b) retirement account;

(c) Pension plan;

(d) Keogh plan;

(e) Individual retirement account (IRA);

(f) Independence Account; or

(g) Other retirement accounts as defined by the IRS.

(4) For an applicant or participant to be eligible for Medical Assistance benefits under this chapter, the countable resources attributed to the applicant's or participant's assistance unit pursuant to §§C and D of this regulation may not exceed $10,000 for an individual.

D. Independence Accounts.

(1) Account Provisions.

(a) Contributions to any of the participant's registered Independence Accounts are subject to the rules described in this section and to any policies of the respective financial institution governing the account.

(b) All contributions to the participant's Independence Account or accounts, including interest, dividends, or other gains from the principal, shall be treated as an exempt asset for the purpose of calculating eligibility for Medical Assistance and the EID program.

(c) The purpose of an Independence Account is to allow the participant to purchase any items or services that may aid in the participant's pursuit of personal or financial independence.

(d) The EID participant shall be the sole owner of any account registered as an Independence Account.

(e) The Department shall assess the participant's Independence Account as a part of the verification process at redetermination for Medical Assistance. The review process shall include verifying all contributions to the participant's Independence Account with the financial institution holding the participant's account.

(f) The total amount a participant deposits in all independence accounts during an annual certification period may not exceed the participant's gross earned income for that annual certification period.

(2) Independence Account Registration.

(a) A person shall complete an account registration form to register an applicable account as an Independence Account with the Department.

(b) A person shall re-register the Independence Account with the Department if the financial institution or other information for the Independence Account changes.

(c) The applicant or participant shall report any changes in personal or financial status that may affect the applicant's or participant's eligibility for Medical Assistance as described in COMAR 10.09.24.

(d) For all registered Independence Accounts, the date of account creation may be no earlier than the date an EID participant is determined eligible for Medical Assistance under this section.

(e) For all registered Independence Accounts, the funds in the Independence Account shall be held separate from the participant's nonexempt assets.

Md. Code Regs. 10.09.41.04

Regulations .04 adopted as an emergency provision effective April 1, 2006 (33:9 Md. R. 795); adopted permanently effective July 3, 2006 (33:13 Md. R. 1063)
Regulation .04 amended as an emergency provision effective October 1, 2008 (35:22 Md. R. 1955); amended permanently effective February 9, 2009 (36:3 Md. R. 208)
Regulation .04D amended effective 40:10 Md. R. 917, eff.5/27/2013 ; amended effective 50:25 Md. R. 1087, eff. 12/25/2023