Section 210-RICR-50-00-6.1 - Overview and PurposeA. Financial eligibility for Medicaid LTSS is determined using a multi-faceted process that considers countable income and resources at the time of application, the allocation of joint spousal resources from the point the need for LTSS began, and financial transactions over a look-back period of up to five (5) years. The purpose of this process is not only to assess whether an applicant meets the applicable income and resources limits, but also to ensure that Federal requirements that both prohibit self-impoverishment and protect against spousal impoverishment are met.B. The LTSS financial eligibility requirements differ somewhat depending on whether a person is a current Medicaid beneficiary or a new applicant. The method required by Federal Regulations for evaluating income and resources is linked to the applicable category of Medicaid coverage: modified adjusted gross income (MAGI) method for Affordable Care Act (ACA) expansion adults in Medicaid Affordable Care Coverage (MACC) category or the Supplemental Security Income (SSI) method for adults over age twenty-one (21) in the Integrated Health Care Coverage (IHCC) category.210 R.I. Code R. 210-RICR-50-00-6.1
Adopted effective 1/20/2019
Amended effective 7/21/2021