TN 12 (01-00)

A. Background

It is possible for a married couple who are not physically living together to be considered living together for SSI purposes due to temporary absence rules. For example, if one member of an eligible couple is living in a title XIX facility, the individual may still be considered living with the eligible spouse at home if the individual is temporarily absent as defined in SI 00835.043.

Further, if both members of an eligible couple are in a title XIX facility, but both are temporarily absent as defined in SI 00835.043, they will also be considered to be living together in a household (i.e., not separated). Thus, they may be considered an eligible couple for SSI purposes (i.e., subject to the eligibility test using the couple FBR and combined income and couple resource limit).

B. Policy

1. Temporary Absence

The couple eligibility computation rules are not affected by the temporary absence of a couple member from a household. If one or both members of an eligible couple are in a title XIX facility and a temporary absence exists (as defined in SI 00835.043), then they will be considered living together and the couple computation rules apply.

2. Both Members Temporarily Absent from Home in a Title XIX Facility

1. For months after 6/88, the benefit rate for a couple is $60 a month (prior to 6/88, the rate was $50.00). For payment purposes, the $60.00 payment limit applies only when all of the following conditions are met:

   • Both the man and woman are married or holding themselves out to the community as husband and wife, and

   • Both of them are in a title XIX facility where they are LA:D, and

   • Both of them are temporarily absent as defined in SI 00835.043.

It is immaterial whether they live together in the same room in the title XIX facility, as living together in the same room in an institution does not constitute “living together” for purposes of determining whether a man and woman are an eligible couple (see SI 00501.154B.).

2. If a husband and a wife are considered living together, but both are in a title XIX facility, determine eligibility by subtracting the couple's countable income from the full FBR for a couple. Determine the SSI payment amount by subtracting the couple's countable income from the $60.00 payment limit. (See SI 00520.140 for payment continuation for temporary institutionalization.)

3. One Member Temporarily Absent from Home in a Title XIX Facility

If one member of an eligible couple is temporarily absent as defined in SI 00835.043, they are considered an eligible couple. Determine SSI eligibility by subtracting the couple's combined countable income from the full FBR for a couple. If they are eligible, determine the amount of their SSI payment based on each person's own income.

The couple's benefit rate equals:

• For the months after 6/88, $30 per month for the spouse in the Title XIX facility. (See SI 00520.140 for payment continuation for temporary institutionalization.); plus

• The full FBR for the eligible individual who is not in the Title XIX facility.

C. Procedure

MSSICS cannot handle the eligibility and payment computations for the couple situations shown in the following examples. Follow instructions in MSOM BUSSR 002.004, MSOM BUSSR 002.005, & MSOM BUSSR 002.006 to pay the individuals in these situations.

D. Examples

1. Eligible Couple — One in Own Household, the Other in a Title XIX Facility but Intending to Return Home

Allen and Martha were living together as an eligible couple. On 6/10/2000, Allen entered a title XIX facility for care after an illness. Allen intends to return home when he is able and is temporarily absent per SI 00835.043. While Allen is in the Title XIX facility, he and Martha remain an eligible couple for eligibility computation purposes but are paid as individuals.

Allen receives a Social Security benefit of $400 per month and Martha receives a wife's benefit of $200 per month.

1. The Eligibility Test

   Together, Allen and Martha have countable income of $580 ($400 +$200 - $20). The couple FBR ($769) exceeds the countable income. Therefore, Allen and Martha are an eligible couple.

2. The Payment Computations

   June 2000

   This is the last month for which payment is computed for a couple. The budget month is April.

• July 2000

  Payment for July is computed as if Allen and Martha are individuals. The budget month is May.

2. Both Members of a Married Couple in a Title XIX Facility — No Temporary Absence

Jack and Jill are a married eligible couple living in an apartment. On 01/15, both of them move to a title XIX facility. When they leave their apartment, the lease ceases and they do not intend to resume living together if either one leaves the facility. Thus, they are not considered temporarily absent from the household where they used to live. Effective February, Jack and Jill are considered two eligible individuals (i.e., each has a $2000 resource limit, each person's own income is used in determining eligibility, and subtracted from the $30 payment limit to determine payment amount). (See SI 00501.154B.)

3. Both Members of a Married Couple in a Title XIX Facility — Temporary Absence

Bill and Jane are a married eligible couple living in a home they own. On 01/15, each of them moves to a separate title XIX facility. The facilities are 100 miles apart. Both Bill and Jane intend to return home, and thus, they are considered to be living together in the same household. Effective February, Bill and Jane are still considered an eligible couple (e.g., they have a $3000 resource limit). Their combined total countable income would be subtracted from the couple FBR to determine eligibility and subtracted from the $60.00 payment limit to determine payment.