(a) Scope. The Texas Health and Human Services Commission (HHSC) prepares a noninstitutional eligibility budget to determine financial eligibility for a person or couple in a noninstitutional setting, if the person or couple:
(1) applies for retroactive coverage;
(2) applies for or has eligibility redetermined under a federally mandated Medicaid-funded program for the elderly and people with disabilities as described in §358.107 of this chapter (relating to Coverage Groups); or
(3) applies for or has eligibility redetermined under §1929(b)(2)(B) of the Social Security Act.
(b) Individual budget. In preparing an eligibility budget for a person who meets the criteria in §358.434(a) of this division (relating to Budget Types for a Noninstitutional Setting), HHSC:
(1) counts the person's income in accordance with §1612 of the Social Security Act (42 U.S.C. §1382a);
(2) counts the person's resources in accordance with §1613 of the Social Security Act (42 U.S.C. §1382b);
(3) applies the individual resource limit in accordance with 20 CFR §416.1205; and
(4) applies the appropriate income limit, effective the month of eligibility determination, as follows:
(c) Couple budget. In preparing an eligibility budget for a couple who meets the criteria in §358.434(b) of this division, HHSC:
(1) counts the income of both spouses in accordance with §1612 of the Social Security Act;
(2) counts the resources of both spouses in accordance with §1613 of the Social Security Act;
(3) applies the couple resource limit in accordance with 20 CFR §416.1205; and
(4) applies the appropriate income limit, effective the month of eligibility determination, as follows:
(d) Companion budget. In preparing an eligibility budget for a person who meets the criteria in §358.434(c) of this division, HHSC:
(1) counts the income of both spouses in accordance with §1612 of the Social Security Act;
(2) counts the resources of both spouses in accordance with §1613 of the Social Security Act;
(3) deems the ineligible spouse's income and resources;
(4) applies the couple resource limit in accordance with 20 CFR §416.1205; and
(5) applies the appropriate income limit, effective the month of eligibility determination, as follows:
Source Note: The provisions of this §358.435 adopted to be effective September 1, 2009, 34 TexReg 5497