10.09.41.04

.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, whether an applicant or recipient meets the income standards for eligibility for the EID coverage group.

(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. For an applicant or recipient to be eligible for Medical Assistance benefits under this chapter, the total countable net income attributed to the applicant's or recipient's assistance unit pursuant to §B of this regulation may not exceed 300 percent of the federal poverty level for a family unit size equivalent to the number of individuals in the assistance unit, determined in accordance with §A of this regulation.

C. Consideration of Resources.

(1) Except as provided in this section or §D of this regulation, whether an applicant or recipient 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 assistance unit, 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 assistance unit.

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

(a) 401(k) retirement account;

(b) 403(b) retirement account;

(c) Pension plan; or

(d) Keogh plan.

D. Resource Standards. For an applicant or recipient to be eligible for Medical Assistance benefits under this chapter, the countable resources attributed to the applicant's or recipient's assistance unit pursuant to §D of this regulation may not exceed:

(1) $10,000 for an individual; and

(2) $15,000 for an individual with a spouse.