Form Des-602 Consideration Of Resources In Continuing Eligibility
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1Maryland Medical Assistance Program
Consideration of Resources in Continuing Eligibility
Date: ____________________
Re: ____________________________________
Case Name
________________________________________
C.I.D. Number
Dear ____________________________________ :
Recently the above-named person was found eligible for Medical Assistance. This
determination was based on a consideration of resources in which a portion of the couple’s total
combined resources were not counted because it was to be protected for the benefit of the spouse
living in the community. For the purpose of determining Medical Assistance eligibility, the
resources were considered as follows:
Couple’s Total Combined Resources
$ _____________
Amount Protected for the Community Spouse
- ______________
Amount Attributed to the Institutionalized Spouse
______________
Currently the amount owned by the institutionalized spouse exceeds the amount that has
been attributed to him/her. This excess amount must be made available to the community spouse.
The excess amount is calculated as follows:
Amount Owned by Institutionalized Spouse
$ _____________
Amount Attributed to the Institutionalized Spouse
- ______________
Excess Amount
$ _____________
The Excess Amount above will be protected for the community spouse. This amount
prevents the institutional spouse from exceeding the allowable $2500 resource amount. You are
responsible for removing this excess amount from the name of the institutionalized spouse and
making it available to the community spouse. You have 90 days from the date of this notice to
make changes and to provide this agency with proof that the changes have been made. The
next time this case is reviewed, all resources remaining in the name of the institutionalized spouse
will be counted. Failure to remove the excess from the name of the institutionalized spouse, and
to make it available to the community spouse, will result in cancellation of Medical Assistance.
When the excess amount has been transferred from the institutionalized spouse to the
community spouse, you must send verification to this department. This verification should be
received no later than ______________________________.
Sincerely,
_____________________________________________
Case Manager
_____________________________________________
Department of Social Services
_____________________________________________
Telephone Number
DES 602 (LTC) Revised 7/02
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