Or. Admin. R. 461-135-0745 – Eligibility for Individuals in Acute Care Settings; OSIPM

An individual in an acute care hospital or nursing facility is evaluated for Oregon Supplemental Income Program Medical (OSIPM) as follows:

(1) The individual must meet all non-financial eligibility requirements for OSIPM.
(2) Individuals are considered in their own household group (see OAR 461-110-0210) and filing group (see OAR 461-110-0410).
(3) The financial group (see OAR 461-110-0530) consists only of the individual applying for benefits, except that the spouse (see OAR 461-001-0000) is included in the financial group to determine initial eligibility as follows:
1. (a) At initial eligibility, the resources of the spouse are considered and the provisions of OAR 461-160-0580 apply.
2. (b) The income of the spouse is not considered in determining initial eligibility, and the spouse is not included in any other eligibility group.
(4) The individual must have countable (see OAR 461-001-0000) income at or below 300 percent of the full Supplemental Security Income (SSI) standard or have established a qualifying trust as specified in OAR 461-145-0540(9)(c).
(5) The individual is subject to the home equity limits as described in section (2) of OAR 461-145-0220.
(6) The individual must require a continuous period of care (see OAR 461-001-0030).

ORS 409.050, 411.060, 411.070, 411.404, 413.085 & 414.685

ORS 409.010, 411.060, 411.070, 411.404, 413.085 & 414.685