627.05 Allocation to Dependents Who Reside with the Community Spouse SR 21-01, 01/21  (MAM-A)

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Allow an individual to allocate income to dependents who reside with the community spouse, provided the institutionalized individual has a community spouse and meets all of the requirements in Section 627.03, Allocation to a Community Spouse.

Consider an individual a dependent if the individual meets all of the following:

• resides with the community spouse;

• can be claimed as a legal dependent on IRS tax returns as specified in IRS Form 501, Exemptions, Standard Deduction and Filing Information; and

• is the:

• natural or adoptive parent of either spouse;

• minor or dependent natural or adoptive child of either spouse; or

• sibling of either spouse (including half-, step-, and siblings from legal adoption).

Steps to Allocate Income to a Dependent who Resides with the Community Spouse

• Use BFA Form 799, Spousal Income Protection, and BFA Form 799A, Income Computation Worksheet for Allocation of Income for Institutionalized Individuals.

• Follow the step-by-step procedures.

1. Determine the dependent's available gross countable income.

2. Subtract the dependent's countable gross income from the maximum income standard (MIS) $2,155.
   (If the dependent's income is higher than $2,155 do not allocate.)

3. Divide the result by 3.

4. The result is the dependent allowance.

5. Repeat Steps 1 through 4 for each dependent to determine the allowance for each dependent.

6. Add all the dependents' allowances together. The total is the family allowance.

7. Subtract the total family allowance from the institutionalized individual's available income that is subject to allocation.
   The available income subject to allocation was determined in Section 627.03, Allocation to a Community Spouse, Step 7.

8. The result in Step 7 is the maximum amount of income to allocate to the dependents.

9. Allocate the institutionalized individual's income that is subject to allocation. The institutionalized individual must allocate their income to dependents residing with the community spouse, when there is income available to allocate. The institutionalized individual cannot refuse to allocate.

References: He-W 606.75; He-W 654.21; 42 CFR 435.725; 42 CFR 435.733; 42 USC 1396r-5(d)(2)-(4)