When the couple lives together, the payment computation steps are the same as those
reflected in SI 02009.050 with the additional step of dividing the monthly amount due to the couple by 2 to
obtain the amount due to each member of the couple.
NOTE: When the couple is living together with their essential person(s): (a) the increment(s)
for the essential person(s) is added to the couple's FBR, (b) all the income of the
essential person(s) is deemed, i.e., included in the couple's countable income,
and (c) the couple's monthly payment amount is evenly divided between each member
of the couple regardless of whether the essential person was designated essential
to a specific member of the couple or both members of the couple.
Example 1:
Bill and Beth Geiger are an eligible couple living in their own household during the
third quarter of 1981. They have three essential persons living with them, one of
whom has earned income of $75 a month. Mr. and Mrs. Geiger each receive a title II
benefit of $125 per month. The computation for the third quarter of 1981 is as follows:
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Example 1
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$1191.00
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Quarterly FBR for 3rd quarter 1981
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$1193.40
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Essential person increments (3x$397.80=$1193.40)
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$2384.40
|
|
$ 915.00
|
Countable income (3x$250+$225=$975-$60=$915)
|
$1469.40
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Quarterly payment amount
|
$ 480.80
|
Monthly payment amount to the couple
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$ 244.90
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Monthly payment amount to each member
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Example 2:
Same situation as Example 1 except the essential person who was working died on August
2. Bill had no income in August. The computation for the third quarter of 1981 becomes:
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Example 2
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$1191.00
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Quarterly FBR
|
$1060.80
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Essential person increment (2x$397.80+265.20=$1060.80)
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$2251.80
|
|
$ 765.00
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Countable income ($3x$250+$75=$825-$60=$765)
|
$1486.80
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Quarterly payment amount
|
$ 495.60
|
Monthly payment amount to the couple
|
$ 247.80
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Monthly payment amount to each member
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Example 3:
Judy and Thomas Punker are an eligible couple living in their own household. They
have an essential person living with them who has earned income of $90 per month.
The essential person is designated as essential to Judy. The couple has no other income.
On July 3, 1981, Thomas enters a title XIX facility and Medicaid immediately-begins
to pay over 50 percent of the costs. This results in a permanent separation from Judy.
The computation follows:
Couple Status Short Quarter of July
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Example 3
|
$397.00
|
FBR for the short quarter of couple status
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$132.60
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Essential person increment for the short quarter
|
$529.60
|
|
$ 70.00
|
Countable income ($90 deemed from the essential person less $20 general exclusion)
|
$459.60
|
Short quarter payment amount to the couple
|
$229.80
|
Monthly payment amount to each member
|
Individual Status Short Quarter of August/ September
Mr. Punker
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Example 3 cont.
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$50.00
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FBR for the short quarter of individual status
|
$ 0.00
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Countable income
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$50.00
|
Short quarter payment amount
|
$25.00
|
Monthly payment amount
|
Mrs. Punker
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Example 3 cont.
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$ 529.40
|
FBR for the short quarter of individual status
|
$ 265.20
|
Essential person increment for the short quarter
|
$ 794.60
|
|
$ 140.00
|
Countable income ($90x2= $180-$40=$140)
|
$ 654.60
|
Short quarter payment amount
|
$ 327.30
|
Monthly payment amount
|
Example 4:
Same as above except that Thomas' hospitalization is a temporary absence and the essential
person is designated as essential to Thomas. Thomas returns home on October 7, 1981.
The computation for the period July through September is the same as in the prior
example; i.e., the essential person increment is given to Judy, and the essential
person income is deemed to Judy. The computation for October through December is:
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Example 4
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$1191.00
|
Quarterly FBR
|
$ 397.80
|
Essential person increment ($132.60x3)
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$1588.80
|
|
$ 210.00
|
Countable income ($90x3=270-$60=$210)
|
$1378.80
|
Quarterly payment amount
|
$ 459.60
|
Monthly payment amount to the couple
|
$ 229.80
|
Monthly payment amount to each member
|