OAR 461-110-0530: Financial Group

(1) 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. (2) For Medicare Savings Programs (see OAR 461-001-0000), Oregon Supplemental Income Program Medical-Employed Persons with Disabilities (OSIPM-EPD), and the Supplemental Nutrition Assistance Program (SNAP), the financial group consists of each individual in the filing group . (3) 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. (4) In the Oregon Supplemental Income Program Medical (OSIPM) (except OSIPM-EPD): (a) 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. (b) When an individual lives in a standard living arrangement (see OAR 461-001-0000): (A) Except as provided in paragraph (B) of this subsection, each member of the filing group is in the financial group . (B) When an individual is legally married (see OAR 461-001-0000), 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): (i) 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. (ii) 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 . (iii) 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 . (c) 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 eligibility as follows: (A) 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. (B) The income of the community spouse is not considered in determining 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. (C) This subsection applies at initial eligibility or when an individual becomes legally married , whichever occurs later. (5) In the TANF program, the financial group consists of each individual in the filing group except the following: (a) 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 . (b) The spouse of a caretaker relative , when the caretaker relative meets the requirements under subsection (a) of this section. (c) A dependent child of a caretaker relative when the caretaker relative meets the requirements under subsection (a) of this section. (d) An individual who is eligible for and receives an SSI cash payment.