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TitleInstitutionalized Persons
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Page 1


State of Maryland Medical Assistance Manual
Revised July 2012

Section 1000 Table of Contents

Eligibility for Institutionalized Persons

1000.1 Introduction – Eligibility for Institutionalized Persons
(a) The Meaning of Institutionalized

(b)The Assistance Unit

(c) Non- Financial Eligibility Requirements

(d) Period Under Consideration

(e) Resources

(f) Spousal Impoverishment

(g) Income Evaluation

(h) Determining Total Monthly Income

(i) Determining Monthly Available Income

(1) Personal Needs Allowance

(2) Residential Maintenance Allowance

(3) Spousal Allowance

(4) Family/Dependent Allowance

(5) Medicare and Other Health Insurance Premiums

(6) Medical Care or Remedial Services

1000.2 Cost of Care

1000.3 Eligibility Determination and Certification

1000.4 Available Income Less Than Cost of Care

1000.5 Available Income Equal to Cost of Care

1000.6 Available Income Greater Than Cost of Care

1000.7 Determine Excess Available Income

1000.8 Determine Spend-Down Eligibility

1000.9 Continuing Eligibility

1000.10 Scheduled Redetermination

1000.11 Interim Changes

(a) Timely Reporting, LDSS Action and Notification

(b) Changes Not Reported in a Timely Manner

(c) Changes Not Acted Upon in a Timely Manner

(d) Change in Resources

(e) Proper Reduction of Excess Resources

(f) Change in Income

Page 89


State of Maryland Medical Assistance Manual
Revised July 2012


What do I do if I think your decision is wrong?

• Call the telephone number on the other side of this notice to ask for a conference.

• Request a hearing by:

• Calling 1-800-332-6347 or the telephone number on the other side of this notice and requesting a hearing; or

• Visiting your local department office and requesting a hearing; or

• Mailing or giving a request for a hearing in writing to:

• Your local department office; or

• The following address:

DHMH Docketing – Unit A

Office of Administrative Hearings

11101 Gilroy Road

Hunt Valley, Maryland 21031-1301

• If you don’t want to fill out the form to request the hearing:

• Come to your local department office. We will help you.

• Call your case manager at the telephone number on this notice or call 1-800-332-6347.

How long do I have to request a hearing?

• You must ask for a hearing no later than 90 days after the date of this notice.

How long can I still get my benefits while I wait for my hearing?

• If you ask for a hearing no later than 10 days after the date of this notice and you were getting benefits, you can

continue to get your benefits while you wait.

Will I owe any money if I get my benefits while I wait?

• If the judge agrees with us and you lose your appeal, you may have to pay back benefits. This might not be


if it is determined that your request for a hearing resulted from a bona fide belief that the department’s decision was

in error.

When and where will the hearing be?

• The Office of Administrative Hearings will send you a notice telling you the time and place of your hearing.

Do I have to come to the hearing?

• Yes. You will lose if you do not come. If you can’t come, tell the Office of Administrative Hearings and they will

reschedule your hearing.

Can I bring someone to help me or speak for me?

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