461-110-0530 Effective 07/01/24
Financial Group
- Except as provided in section (4) of this rule, the "financial group" consists of the filing group (see OAR 461-110-0310) members whose income and resources the Department considers in determining eligibility (see OAR 461-001-0000) and benefits.
- In the Oregon Supplemental Income Program Medical – Employed Persons with Disabilities (OSIPM-EPD), Qualified Medicare Beneficiaries (QMB), and Supplemental Nutrition Assistance Program (SNAP), the "financial group" consists of each individual in the filing group.
- In the Refugee Assistance (REF) and Refugee Assistance Medical (REFM) programs, the "financial group" consists of each individual in the filing group, except an individual who is eligible for and receives a Supplemental Security Income (SSI) cash payment.
- In the Oregon Supplemental Income Program Medical (OSIPM) (except OSIPM-EPD):
- For the purposes of this section of this rule, "ineligible" means an individual not eligible to receive either SSI or Temporary Assistance for Needy Families (TANF) program benefits.
- When an individual lives in a standard living arrangement (see OAR 461-001-0000):
- Except as provided in paragraph (B) of this subsection, each member of the filing group is in the "financial group".
- When an individual is married, not assumed eligible (see OAR 461-135-0010) for OSIPM, and the individual's spouse (see OAR 461-001-0000) is considered "ineligible" (see subsection (a) of this section):
- If the individual's adjusted income (see OAR 461-001-0000) using the deductions allowed under OAR 461-160-0550(4), or after being evaluated under certain protected groups (see OAR 461-135-0771 to OAR 461-135-0830), is greater than the OSIPM program adjusted income standard for a need group of one under OAR 461-155-0250, the individual is in their own “financial group” and not eligible for OSIPM.
- When there are children in the home, if the ineligible spouse's remaining countable (see OAR 461-001-0000) income after allocation (see OAR 461-160-0551) to each ineligible child is equal to or less than the difference between the couple and the individual SSI standards: the spouse is not included in the "financial group" when determining income eligibility; however, the spouse is included in the "financial group" when determining resource eligibility.
- When there are no children in the home, if the ineligible spouse’s countable income is less than the difference between the couple and the individual SSI standards: the spouse is not included in the “financial group” when determining income eligibility; however, the spouse is included in the "financial group" when determining resource eligibility.
- When an individual is in a nonstandard living arrangement (see OAR 461-001-0000), or the individual is being evaluated under OAR 461-135-0745, and the community spouse is not in the household group; the community spouse is included in the “financial group” to determine initial eligibility as follows:
- At initial eligibility, the resources of the community spouse are considered in order to calculate the community spouse resource allowance and the provisions of OAR 461-160-0580 apply.
- The income of the community spouse is not considered in determining initial eligibility except when calculating the community spouse resource allowance as specified in OAR 461-160-0580, and the community spouse is not included in any other eligibility group.
- In the TANF program, the "financial group" consists of each individual in the filing group except the following:
- A caretaker relative, other than a parent, who chooses not to be included in the need group and has income less than the non-needy countable income limit standard (see OAR 461-155-0030) for the filing group of the caretaker relative.
- The spouse of a caretaker relative, when the caretaker relative meets the requirements under subsection (a) of this section.
- A dependent child of a caretaker relative when the caretaker relative meets the requirements under subsection (a) of this section.
- An individual who is eligible for and receives an SSI cash payment.
Statutory/Other Authority: ORS 409.050, 411.060, 411.070, 411.404, 411.706, 411.816, 412.006, 412.049, 412.064, 412.124, 413.085, 414.619, 414.712
Statutes/Other Implemented: ORS 409.010, 411.060, 411.070, 411.404, 411.706, 411.816, 412.006, 412.049, 412.064, 412.124, 414.712, 414.826, 414.117