(a) Both members of a couple live in another person's household and receive food and shelter from that person. When both of you live in another person's household throughout a month and receive food and shelter from that person, we apply the one-third reduction to the Federal benefit rate for a couple (Sec. 416.1131).
(b) One member of a couple lives in another person's household and receives food and shelter from that person and the other member of the couple is in a medical institution. (1) If one of you is living in the household of another person who provides you with both food and shelter, and the other is temporarily absent from the household as provided in Sec. 416.1149(c)(1) (in a medical institution that receives substantial Medicaid payments for his or her care (Sec. 416.211(b))), and is ineligible in the month for either benefit payable under Sec. 416.212, we compute your benefits as if you were separately eligible individuals (see Sec. 416.414(b)(3)). This begins with the first full calendar month that one of you is in the medical institution. The one living in another person's household is eligible at an eligible individual's Federal benefit rate and one-third of that rate is counted as income not subject to any income exclusions. The one in the medical institution cannot receive more than the reduced benefit described in Sec. 416.414(b)(3)(i).
(1) If one of you is living in the household of another person who provides you with both food and shelter, and the other is temporarily absent from the household as provided in Sec. 416.1149(c)(1) (in a medical institution that receives substantial Medicaid payments for his or her care (Sec. 416.211(b))), and is ineligible in the month for either benefit payable under Sec. 416.212, we compute your benefits as if you were separately eligible individuals (see Sec. 416.414(b)(3)). This begins with the first full calendar month that one of you is in the medical institution. The one living in another person's household is eligible at an eligible individual's Federal benefit rate and one-third of that rate is counted as income not subject to any income exclusions. The one in the medical institution cannot receive more than the reduced benefit described in Sec. 416.414(b)(3)(i).
(2) If the one member of the couple in the institution is eligible for one of the benefits payable under the Sec. 416.212 provisions, we compute benefits as a couple at the rate specified under Sec. 416.412. However, if that one member remains in the institution for a full month after expiration of the period benefits based on Sec. 416.212 can be paid, benefits will be computed as if each person were separately eligible as described under paragraph (c)(1) of this section. This begins with the first calendar month after expiration of the period benefits based on Sec. 416.212 can be paid.
(c) Both members of a couple are subject to the presumed value rule. If the presumed value rule applies to both of you, we value any food or shelter you and your spouse receive at one-third of the Federal benefit rate for a couple plus the amount of the general income exclusion (Sec. 416.1124(c)(12)), unless you can show that their value is less as described in Sec. 416.1140(a)(2).
(d) One member of a couple is subject to the presumed value rule and the other member is in a medical institution. (1) If one of you is subject to the presumed value rule and the other is temporarily absent from the household as provided in Sec. 416.1149(c)(1) (in a medical institution that receives substantial Medicaid payments for his or her care (Sec. 416.211(b))), and is ineligible in that month for either benefit payable under Sec. 416.212, we compute your benefits as if both members of the couple are separately eligible individuals (see Sec. 416.414(b)(3)). This begins with the first full calendar month that one of you is in the medical institution (see Sec. 416.211(b)). We value any food or shelter received by the one outside of the medical institution at one-third of an eligible individual's Federal benefit rate, plus the amount of the general income exclusion (Sec. 416.1124(c)(12)), unless you can show that their value is less as described in Sec. 416.1140(a)(2). The member of the couple in the medical institution cannot receive more than the reduced benefit described in Sec. 416.414(b)(3)(i).
(1) If one of you is subject to the presumed value rule and the other is temporarily absent from the household as provided in Sec. 416.1149(c)(1) (in a medical institution that receives substantial Medicaid payments for his or her care (Sec. 416.211(b))), and is ineligible in that month for either benefit payable under Sec. 416.212, we compute your benefits as if both members of the couple are separately eligible individuals (see Sec. 416.414(b)(3)). This begins with the first full calendar month that one of you is in the medical institution (see Sec. 416.211(b)). We value any food or shelter received by the one outside of the medical institution at one-third of an eligible individual's Federal benefit rate, plus the amount of the general income exclusion (Sec. 416.1124(c)(12)), unless you can show that their value is less as described in Sec. 416.1140(a)(2). The member of the couple in the medical institution cannot receive more than the reduced benefit described in Sec. 416.414(b)(3)(i).
(2) If one of you is subject to the presumed value rule and the other in the institution is eligible for one of the benefits payable under Sec. 416.212, we compute the benefits as a couple at the rate specified under Sec. 416.412. However, if the one in the institution remains in the institution after the period benefits based on Sec. 416.212 can be paid, we will compute benefits as if each member of the couple were separately eligible as described in paragraph (d)(1) of this section. [60 FR 16375, Mar. 30, 1995, as amended at 61 FR 10279, Mar. 13, 1996; 70 FR 6345, Feb. 7, 2005] Sec. 416.1147a Income rules in change-of-status situations involvingin-kind support and maintenance.
(a) General. This section explains the rules for determining countable income, including in-kind support and maintenance, when eligible individuals become an eligible couple or when an eligible couple becomes eligible individuals. Generally, under retrospective monthly accounting, income in a prior month, including in-kind support and maintenance, affects benefit amounts for a current month. The prior month may be the first or second month prior to the current month (as explained in Sec. 416.420(a)) and the rules in this section apply when a change-of-status becomes effective between the prior month and the current month.
(b) Eligible individuals become an eligible couple. If you and your spouse have been eligible individuals and become an eligible couple, we combine the earned and unearned income each of you had as an eligible individual in the prior month. If either or both of you received in-kind support and maintenance, we include its value as income. This may be one-third of the Federal benefit rate that applied in the prior month for one or both of you who lived in the household of another. It may be the presumed maximum value (one-third of the Federal benefit rate plus $20 as explained in Sec. 416.1140) for one or both of you as appropriate. It may also be a combination of the two if each of you received income in one of these forms. We also include income deemed to either or both of you in the prior month.
(c) Eligible couple becomes one or two eligible individuals. If you are an eligible individual in the current month but were a member of an eligible couple in the prior month, we determine your countable income in the prior month separately from that of your spouse. We determine the value of any in-kind support and maintenance you and your spouse received in the prior month using the rules contained in Sec. 416.1147. For example, if both of you lived in the household of another and the one-third reduction applied, each of you would have income equal to one-sixth of the Federal benefit rate fov a couple. Also, for example, if you received in-kind support and maintenance and the presumed maximum value applied, you would have income equal to one-sixth of the Federal benefit rate for a couple, plus $10. We divide any other income you had as an eligible couple according to who owned the income. If ownership of jointly owned income cannot be determined, we allocate one-half of it to you. [50 FR 48575, Nov. 26, 1985]