DHS 10.34(3)(b)1.1. Determine total countable assets according to ss. 49.454 and 49.47, Stats., and s. DHS 103.06. If the applicant or enrollee is legally married, include the countable assets of both members of the couple.

DHS 10.34(3)(b)2.2. Determine monthly net countable assets by subtracting from total countable assets the following allowances, as applicable, and dividing the result by 12:

DHS 10.34(3)(b)2.a.a. Subject to subd. 6., if the applicant or enrollee is a family care spouse, the amount of the community spouse resource allowance under s. 49.455 (6) (b), Stats.

DHS 10.34(3)(b)2.b.b. If the person resides in a nursing home, community-based residential facility or adult family home, an allowance of $9,000.

DHS 10.34(3)(b)2.c.c. If the person resides in his or her own home, including a residential care apartment complex or in the private home of a relative or other person, an allowance of $12,000.

DHS 10.34(3)(b)3.a.a. Monthly unearned income less a $20 disregard from unearned income, or if the person has less than $20 of unearned income, the remainder from earned income.

DHS 10.34(3)(b)3.b.b. Total monthly earned income, less the first $200, and then less two-thirds of any remaining earned income.

DHS 10.34(3)(b)5.a.a. Subject to subd. 6., if the person is a family care spouse, the community spouse monthly income allowance under s. 49.455 (4) (b), Stats.

DHS 10.34(3)(b)5.c.c. If the person resides in a nursing home, community-based residential facility or adult family home, a personal maintenance allowance of $65.

DHS 10.34(3)(b)5.d.d. If the person resides in his or her own home, including a residential care apartment complex or the home of another person, a personal maintenance allowance equal to the greater of the combined benefit amount available under 42 USC 1381 to 1383 and s. 49.77 (3s), Stats., or actual maintenance costs, as defined under sub. (1) (a), up to the maximum personal maintenance allowance for persons receiving home and community-based waiver services funded under 42 USC 1396 (b) or (c).

DHS 10.34(3)(b)5.e.e. If the person resides in a medical institution, the monthly cost of maintaining a homestead property when the applicant or enrollee can reasonably be expected to return within 6 months or the anticipated absence of the applicant or enrollee from the home is for more than 6 months but there is a realistic expectation, as verified by a physician, that the person will return to the home. The monthly cost shall not exceed the SSI payment level for one person living in that person’s own household.

DHS 10.34(3)(b)5.f.f. The average monthly out-of-pocket cost of necessary medical or remedial care, including health insurance premiums and cost-sharing requirements for other state or federal programs.

DHS 10.34(3)(b)5.g.g. An allowance for dependents who live in the home of the person or the person’s community spouse equal to the allowance payable under s. 49.455 (4) (a) 3., Stats.

DHS 10.34(3)(b)6.6. If both members of a married couple are family care spouses, the community spouse resource allowance under subd. 2. a. and the community spouse monthly income allowance under subd. 5. a. may be included in the calculation of cost share for either spouse, but not for both.

DHS 10.34(3)(c)(c) Recalculation of maximum cost-sharing requirement during a certification period. When changes in income, assets or cost of care necessitate a re-determination of a person’s maximum cost-sharing requirement during a certification period as described in par. (f), the calculation for the remainder of the certification period shall be the same as under par. (b) except that the amount already incurred and paid by the person from countable assets during the certification period shall be added to the amount under par. (b) 4.

DHS 10.34(3)(d)(d) Treatment of assets. In determining financial eligibility and cost sharing requirements for the family care benefit, the department or the county agency shall treat assets, including assets in trusts, according to ss. 49.454 and 49.47 (4) (b), Stats., and s. DHS 103.06, except as follows:

DHS 10.34(3)(d)1.1. All funds in an independence account shall be considered as an exempt asset. In this subdivision, “independence account” means one or more separate accounts at a financial institution, approved by the department, that are in the sole ownership of the client, and that consist solely of savings, and dividends or other gains derived from those savings, from earned income received after application for the family care benefit.

DHS 10.34(3)(e)(e) Treatment of income. In determining financial eligibility and cost sharing requirements for the family care benefit, the department or the county agency shall treat income according to applicable provisions of s. 49.47 (4) (c), Stats., and s. DHS 103.07 except that worker’s compensation cash benefits under ch. 104, Stats., and unemployment insurance benefits received under ch. 108, Stats., shall be treated as earned income for purposes of par. (b) 3. b.

DHS 10.34(3)(f)(f) Certification period. Cost sharing requirements as determined under this section shall be in effect for a full 12-month certification period except as follows:

DHS 10.34(3)(f)1.1. An enrollee shall report, within 10 days of the change, increases in assets that exceed a total of at least $1000 in a calendar month.

DHS 10.34(3)(f)2.2. At any time, an enrollee may report decreases of any amount in assets other than decreases resulting from payment of required cost sharing under this section.