TN 24 (09-23)

SI 02005.084 MMSS Eligibility and Payment Computations Under RMA

A. Policy

MMSS payments are always computed using countable income received in the CM. To be eligible for MMSS, an individual's MIL must be greater than the sum of:

• CM FCI/SCI;

• In-kind income in the CM, if any; and

• Federal eligibility amount.

B. Definitions

1. Federal Eligibility Amount

The Federal eligibility amount is the difference between the CM FBR and the CM FCI.

2. Value Of The One-Third Reduction (VTR)

The Value of the One-Third Reduction (VTR) is the income value assigned (for Federal purposes) to in-kind support and maintenance received by an SSI recipient when living in the household of another during the CM. (See SI 00835.200 ff. and SI 02005.084D.2.)

3. In-Kind Income

In-kind income is the value assigned to in-kind support and maintenance for MMSS purposes only. It may or may not be the same amount as the VTR.

C. Procedure

1. MMSS Eligibility

Use the following formula to determine an individual's MMSS eligibility: MMSS eligibility = MIL - (CM Federal eligibility amount + CM FCI/SCI + CM in-kind income).

2. MMSS Payment Computation

1. a.

Use the following formula to compute an individual's MMSS payment: MMSS payment = MIL - (CM Federal payment + CM FCI/SCI + CM in-kind income).

2. b.

The difference represents the MMSS payment. Compare that amount to any optional State supplementation (OSS) payable and pay the higher amount. If the two payments are equal, pay the OSS.

NOTE: Always perform MMSS computations separately for each recipient, even for members of an eligible couple. The MIL and the income used in eligible couple cases are affected by both members; but the computation to determine eligibility and payment is performed separately.

D. Examples

There are three different methods to apply the MMSS eligibility and payment computation formulas depending on the individual's living arrangement in December 1973 and their CM Federal living arrangement (FLA). FLA's are defined in SI 01415.001. Use the chart below to decide which method applies.

 December 1973 Federal Living Arrangement ​ ​ A B C D CM FLA A Method 1 Method 1 Method 1 Method 1 ​ B Method 2 Method 1 Method 2 Method 2 ​ C Method 1 Method 1 Method 1 Method 1 ​ D Method 3 Method 3 Method 3 Method 1

1. Method 1 — Basic MMSS Computations

1. a.

This is the basic MMSS computation. Use it when neither the VTR nor the FBR payment limit for living in a title XIX facility applies, with two exceptions. Do not use this formula for:

• Recipients converted in the household of another and currently subject to the VTR (whether or not the individual was continually subject to the VTR). The VTR has already been taken into account in the MIL, and it is unnecessary to consider it again in the computation. Follow method 2 for recipients currently subject to the VTR who were not converted in FLA-B.

• Recipients converted in a title XIX institution and currently residing in a title XIX institution (whether or not the individual was continually in FLA-D). Follow method 3 for recipients residing in a title XIX facility who were not converted in FLA-D.

2. b.

Example

• Basic Computation

Franklin Hightower has a MIL of \$400. In January 1990, Franklin's income is a \$120 per month private pension. In November and December 1989, in addition to the pension, Franklin received rental income of \$139.70 per month. FCI may be used in place of SCI in the computation. Compute their MMSS for January 1990.

• The Eligibility Test

 \$400 MIL in January -100 FCI in January (\$120 pension - \$20 general exclusion) -286 Federal eligibility amount based on January FCI (\$386 FBR - \$100 FCI) \$ 14 Franklin is eligible for MMSS
• The Payment Computation

The amount of Franklin's January Federal SSI benefit is based on their income from November, the Federal BM.

 \$386.00 FBR in January -239.70 FCI in November (\$120 pension +\$139.70 rent - \$20 general exclusion) \$146.30 Federal payment due for January

The amount of Franklin's MMSS is based on their Federal payment and FCI for January.

 \$400.00 MIL in January -100.00 FCI in January -146.30 SSI for January \$153.70 MMSS for January

If Franklin is due an OSS payment equal to or greater than \$153.70, pay the OSS instead of the MMSS.

2. Method 2 — Individual Subject To The VTR For Federal Purposes

1. a.

Use method 2 when an eligible individual or couple:

• Were converted to SSI in FLA-A, C, or D (but not B); and

• Begin living in the household of another and receiving food and shelter (i.e., subject to the VTR).

2. b.

The MMSS VTR can never exceed the value of one-third of the A FBR in effect at the time that the most recent move into FLA-B became effective. When only one member of a couple meets the above requirements, the amount of the MMSS VTR is limited to one-sixth of the couple's FBR at the time that the most recent move into FLA-B became effective.

3. c.

Follow these steps to determine the amount of the in-kind income for MMSS purposes.

• Step (1): Subtract the computation month's FCI (never use SCI) from the FBR in effect at the time of the most recent change to the household of another. If this results in an amount of zero or less, no in-kind income for MMSS purposes exists.

• Step (2): Subtract the computation month's FCI (never use SCI) from the FBR in effect at the time of the most recent change to the household of another less one-third. If the result is zero or less, use zero in step 3.

• Step (3): Subtract the result obtained in step (2) from the result obtained in step (1). The remainder is the amount of in-kind income in the month for MMSS purposes.

4. d.

This example shows the MMSS computation involving the VTR.

Individual Becomes Subject To The VTR

Adam was converted to SSI in an FLA-A with a MIL of \$400. They have no income other than SSI. In February 1990, Adam moves into their nephew's home, and begins receiving both food and shelter. Compute the March 1990 MMSS as follows:

• In-kind Income Computation:

Step (1):

 \$386.00 FBR in March (effective month of move) - 0.00 FCI in March \$386.00 Step (1) Result

Step (2):

 \$257.33 FBR in March less the VTR - 0.00 FCI for March \$257.33 Step (2) Result

Step (3):

 \$386.00 Step (1) Result -257.33 Step (2) Result \$128.67 In-kind income for March for MMSS purposes
• MMSS Computation for March 1990:

 \$400.00 MIL -386.00 (\$ 257.33 March Federal payment +0 FCI/SCI + \$128.67 MMSS in-kind income) \$ 14.00 MMSS Payment for March

3. Method 3 — MMSS Suspended For Living In A Title XIX Facility

1. a.

State supplementary payments may be suspended in months during which an individual's Federal payment limit is \$30 (effective July 1, 1988) due to their stay in a title XIX facility. Upon discharge from the institution, the individual may again receive federally administered MMSS payments based on the MIL or, if higher, a federally administered OSS.

NOTE: (1) MMSS payments are not suspended if the individual was converted in December 1973 while residing in a Medicaid facility. (2) The benefits described in section 1619 of the act and sections 1611(e)(1)E and 1611(e)(1)G of the act do not apply to the above discussions about title XIX institutions.

2. b.

When only one member of an eligible couple resides in a title XIX facility, MMSS computations follow the Federal rule that each member of the couple is treated as an individual. See SI 02005.030C. for Federal and OSS computations under RMA.

3. c.

Follow these steps to compute the MMSS payment for this couple:

• Establish separate MIL's for each couple member. Follow the procedures in SI 02005.082D.6.

• Compute the MMSS payment for the noninstitutionalized member, and the MMSS payment for the institutionalized member if they was converted in FLA-D, independently.

• From the individual MIL(s) subtract the total of the individual's Federal SSI benefit and Randy's own income.

4. d.

EXAMPLE: One Member of an Eligible Couple Resides in a Title XIX Facility — Other Member in Own Household

Randy and Laura were converted in the same State as eligible individuals in their own households. Randy's MIL was established as \$450 based on a December 1973 GA of \$410 and SCI of \$40. Lauras' MIL was established as \$300 based the December 1973 GA of \$260 and SCI of \$40. Their State of conversion does not elect to maintain supplementary payment levels for passalong purposes. They married in 1975. Their December 1973 incomes and grant amounts were combined to form new MIL's based on couple status.

MIL Computation:

 \$410 Randy's December 1973 GA 260 Lauras' December 1973 GA 40 Randy's December 1973 SCI +40 Lauras' December 1973 SCI \$750

\$750 divided by 2 = \$375 MIL for each couple member.

In September 1990 Laura enters a nursing home and Medicaid covers the entire cost of theircare. For every month that Laura remains subject to the \$30 payment limit, the MMSS payments are suspended.

Randy remains in their own household. Randy continues to receive the \$55 company pension of which \$40 was countable under the State plan. In October 1990 Randy begins receiving a monthly payment of \$10 from a sibling. (Randy's State plan would not have counted the \$10 had it been received in December 1973 because of the State's unearned income exclusion.)

October 1990: This is the first month throughout which Laura is residing in the title XIX facility. Compute Randy's payment as an individual.

Step (1): The MMSS Eligibility Test

 \$450 MIL in October (the original individual MIL) -341 Federal eligibility amount (\$55 pension +\$10 from sister - \$20 general exclusion = \$45 FCI. \$386 FBR - \$45 October FCI = \$341) \$109 - 40 SCI for October \$ 69 Randy is MMSS eligible

Step (2): The MMSS Payment Computation

 \$450 MIL in October (the original individual MIL) -351 Federal payment amount (\$55 pension - \$20 general exclusion = \$35 FCI. \$386 FBR - \$35 August FCI = \$351) \$ 99 - 40 SCI for October \$ 59 MMSS Payment for October

 To Link to this section - Use this URL: http://policy.ssa.gov/poms.nsf/lnx/0502005084 SI 02005.084 - MMSS Eligibility and Payment Computations Under RMA - 09/08/2023 Batch run: 09/08/2023 Rev:09/08/2023