Adult Medicaid Manual MA-2230 FINANCIAL RESOURCES

REVISED 11/01/08 - CHANGE NO. 22-08

I. POLICY PRINCIPLES

Resources are an important factor in determining Medicaid eligibility. Countable resources are compared to a limit established by federal law. An applicant/recipient (a/r) is ineligible for Medicaid if countable resources exceed the resource limit or the “reserve” limit. The DMA-5030, Reserve History Sheet must be used to document resources at application, change in situation and at redeterminations.

A. Resource Policy Rules

1. Resources

Resources are all financial assets that a Medicaid a/r or a person who is financially responsible for him:

a. Owns, or has the right, authority, or power to convert to cash, and

b. Are legally available for the a/r’s support and maintenance.

2. Resource Eligibility Determination

When determining Medicaid eligibility, some assets are countable resources and others are excluded. Always verify resources, determine their availability and whether available resources are countable.

3. Resource Limits

To qualify for Medicaid, the a/r’s countable resources must be equal to or less than the limits listed below:

Number of Persons	M-AABD, C, N, M Resource Limit	M-QB (Q/B/E), M-WD Resource Limit	HCWD Resource Limit
Individual Couple	$2,000 $3,000	$4,000 $6,000	Minimum Community Spouse Resource Allowance (see MA-2231)

4. First Moment

Verify the value of countable liquid resources (see definition in B.3. below) as of the first moment of the month. Increases of resources during the month do not affect eligibility for month of increase.

NOTE: While countable resources are only applied to the resource limit on the first moment of the month following receipt, if they are given away in the

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(I.A.4.)

month of receipt, evaluate for transfer of resources according to MA-2240, Transfer of Assets.

5. Excess Resources

a. If countable resources exceed the allowable limit:

(1) Notify an applicant via the DMA-5097 of excess resources and the opportunity to rebut the value of those resources that can be rebutted (II.G.1.) or reduce the value of resources. Follow the policy in MA-2303, Verification Requirements for Applications, and MA-2304 , Processing the Application, for time frames and disposition instructions when there are excess resources.

(2) Notify a recipient via the DMA-5097 of excess resources and the opportunity to rebut the value of those resources that can be rebutted (II.G.2.) or reduce the value of resources.

(a) Allow the recipient 12 calendar days to provide proof of rebuttal of value or reduction of resources.

(b) If proof of rebuttal or reduction is not received within 12 calendar days, send a timely notice proposing termination for excess resources. Terminate the case unless, the value of the resources are rebutted or resources are reduced prior to the effective date of termination.

b. Refer to I.C., II.G., VII.E., and VIII.E for further instructions on rebutting the value of resources. Refer to I.D. and XIII.H. for further policy on reduction of resources and MA-2240, Transfer of Assets, for allowable transfers that may reduce resources.

6. The following are not considered resources in determining Medicaid eligibility or transfer of assets.

a. Cash to purchase medical or social services, cash placed in an irrevocable burial account, (see XIII. for applying to the burial exclusion), money used as part of a Plan for Achieving Self-Support (PASS) see H. below, and past due SSI benefits placed in a Dedicated Account for a child under age 18 who has a representative payee, (see I. below).

For one calendar month following its receipt, cash paid by a recognized medical or social services program is not a resource provided the cash is not income and not repayment for a bill already paid.

b. Home energy assistance/support and maintenance assistance (HEA/SMA) regardless of how long a person retains it.

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c. Certain stock in Alaska regional or village corporations. Do not include shares of stock held by a native Alaskan in a regional or village corporation as a resource.

B. Types of Resources

There are three types of resources considered when determining Medicaid eligibility - real property, personal property and liquid assets.

1. Real Property

Real property includes land and all buildings or dwellings which are permanently affixed to the land. This includes mobile homes if the county tax office considers them to be real property. Verify with the county tax office.

2. Personal Property

Personal property includes all personal effects and household goods as well as any types of motor vehicles, boats, trailers or farm and garden equipment. (i.e. mobile homes are considered personal property unless county tax office considers the mobile home to be real property. This can be verified by county tax records or office.)

3. Liquid Assets

Liquid assets include cash, bank accounts, certificates of deposit as well as any item that can be converted to cash (i.e. cash value bearing life insurance policy).

C. Rebuttal of Resource Value for Real or Personal Property or Promissory Note

If the value of the a/r’s total resources exceeds the resource limit the a/r can disagree with and rebut the value of real or personal property or a promissory note. The a/r must be informed via the DMA-5097 or DMA-5097S that he has the right to rebut and prove that the resource has a lesser value.

D. Reduction of Resources

In addition to rebuttal, the a/r must be given the opportunity to reduce countable resources which exceed the resource limit. See MA-2303, Verification Requirements For Applications and MA-2304, Processing the Application, for application processing standards. A recipient may reduce resources within the timely notice time frame.

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(I.)

E. Burial Exclusion

Up to $1,500 of otherwise countable liquid assets may be excluded for burial purposes. See Item XIII. below.

F. Protection of Resources

When a married applicant is “institutionalized” for long-term care, the spouse who remains in the community may be able to keep a share of the couple’s assets. This amount is excluded from the countable resources of the institutionalized spouse. This amount is known as the Community Spouse Resource Allowance. See MA-2231, Community Spouse Resource Protection, for instructions.

G. Transfer of Assets

Transfer of assets may result in a period of ineligibility known as a sanction if the a/r or a/r’s spouse requests assistance with institutional services or receives in-home health services and supplies. See MA-2240, Transfer of Assets.

1. Always document in the case record any transfer of assets by the a/r or financially responsible spouse.

2. Include in the documentation the amount of the transfer, date of the transfer, and any other identifying information, etc.

3. Always complete the Assets Transfer Tracking Screen for any a/r to indicate that a transfer of assets evaluation has been completed. Refer to MA-2240, Transfer of Assets, for procedures.

H. Plan to Achieve Self-Support (PASS)

The Social Security Act authorizes the exclusion of resources of an individual who has a disability or is blind when the individual needs such income and resources to fulfill an approved Plan to Achieve Self-Support (PASS).

Verify the exclusion amount by viewing the notice of approval from the SSA office. Since the PASS is issued for a specific period of time and can be amended by SSA due to changes, it should be verified at each redetermination.

I. Dedicated Accounts for Individuals under Age 18

Section 213 of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 requires that when an individual under age 18 becomes eligible for Supplemental Security Income (SSI), and is eligible for past due SSI monthly benefits, the representative payee must establish a dedicated account in a financial institution into which the past due benefits will be paid.

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(I.I.)

Other underpayments of SSI benefits may also be paid into this account by Social Security. No other funds may be deposited into a dedicated account. A dedicated account including any interest earned is excluded from income and is not a countable resource.

Obtain account statements to verify that only past due payments of SSI benefits have been deposited into the dedicated account. If other funds including regular monthly SSI benefit payments have been deposited into the account, it is no longer considered a dedicated account and should be evaluated for being a countable resource.