J-7200, Spousal Co-Payment

Body

Revision 26-3; Effective Sept.1, 2026

Budget Steps

Calculate the person and their spouse's net monthly earned income to determine the co-payment for a spousal companion case. Do this by subtracting the following mandatory payroll deductions:

  • income tax;
  • Social Security tax;
  • required retirement withholdings; and
  • required uniform expenses.

Note: Mandatory payroll deductions also apply to a dependent's earned income in spousal impoverishment cases.

Do not count in-kind support and maintenance income the spouse receives.

Do not allow a separate deduction for maintenance of the home in companion cases. The spousal allowance provides for home maintenance in those cases.

How to Determine Co-Payment for a Spousal Companion Case

  1. Determine the countable net earned and gross unearned income of the person.
  2. Subtract the personal needs allowance (PNA) of $75 for the person. Subtract the guardian fee allowance, if applicable.
  3. Add the spouse's countable net earned and gross unearned income to the remainder. Count only the minimum monthly maintenance needs allowance (MMMNA) if the spouse’s income is more than the minimum monthly maintenance needs allowance MMMNA.
  4. Subtract the spousal allowance.
  5. If there are no dependents, go to step 6.
    If there are dependents, determine the dependent allowance.
    Subtract the dependent allowance.
  6. Subtract incurred medical expenses. The remainder is the co-payment for the payment plan.

Notes:

  • Enter incurred medical expense deductions on the Medical Expense LUW in TIERS even if the payment plan is $0.
  • Follow procedures for an individual payment plan budget if:
    •  the person has signed a statement;
    •  refuses to make the spousal allowance available; and 
    • there are no dependents.
  • Count only the MMMNA in step 3 above if the community spouse's countable income is more than the MMMNA.

Examples

The following examples are for demonstration purposes only. They may not reflect the most recent protected resource amounts or dependent allowance.

A person and their spouse have the following monthly income:

  • Person
    •   $265 RSDI
    • +$200 Private retirement
    • =$465 Total
  • Spouse
    •   $350 RSDI
    • +$285 Teacher's retirement
    • = $635 Total
  • Co-payment calculation:
    • $465 Person's gross income
    • – $75 PNA
    • = $390 Income available for diversion
    • + $635 Spouse's income
    • = $1,025 Total
    • – $4,066.50 Spousal allowance
    • = $0 Co-payment

Another person and their spouse have the following monthly income:

  • Person
    •    $490 RSDI
    • + $509 Private retirement
    • = $999 Total
  • Spouse
    •    $450 RSDI
    • + $300 Private retirement
    • + $750 Net earnings
    • = $1,500 Total
  • Co-payment calculation:
    •    $999 Person's gross income
    • – $75 PNA
    • = $924 Income available for diversion
    • + $1,500 Spouse's income
    • = $2,424 Total
    • – $4,066.50 Spousal allowance
    • = $0 Co-payment

A third person and their spouse have the following monthly income:

  • Person
    •    $1,250 RSDI
    • + $800 Private retirement
    • = $2,050 Total
  • Spouse
    • $1,590 Net earnings

The person's dependent brother lives with the community spouse. The brother’s only income is $590 per month in RSDI disability benefits.

  • Brother’s dependent allowance calculation:
    •    $2,705Base amount of dependent allowance
    • – $590 Dependent's gross income
    • = $2,115Remainder
    •    $2,115divided by 3
    • = $705 Dependent allowance
  • Co-payment calculation:
    •    $2,050 Person's gross income
    • – $75 PNA
    • = $1,975 Income available for diversion
    • + $1,590 Spouse's income
    • = $3,565 Total
    • – $4,066.50 Spousal allowance
    • = $0 Remainder
    • – $705 Dependent allowance
    • = $0.00 Co-payment

Related Policy

Co-Payment, Chapter H