Adult Medicaid Manual MA-2311 LIS PROCESSING AND MAINTENANCE

V. RESOURCES

Unless otherwise indicated in this section, follow rules for determining availability, countable value and exclusions in MA-2230, Financial Resources.

A. Determine Whose Resources are Counted

Count resources available to the applicant and the applicant’s spouse, if living in the home. See MA-2230, Financial Resources, for availability rules.

1. If the applicant or spouse is the sole owner by the account title and can withdraw and use funds from the account, all of the account’s funds are counted as a resource to the applicant/spouse regardless of the source. This presumption is not rebuttable.

NOTE: This is different from Medicaid where a client has an opportunity to prove a resulting trust exists.

2. Jointly-held Account

a. If the applicant/spouse is the only subsidy claimant or subsidy recipient who is an account holder on a jointly held account, presume that all of the funds in the account belong to the applicant/spouse. The client may rebut this presumption and provide proof of a resulting trust or amounts that belong to each individual owner.

b. If more than one subsidy claimant or subsidy recipient are account holders, consider the funds belong to each in equal shares. The client may rebut this presumption.

REVISED 03/01/12 – CHANGE NO. 05-12

(V)

B. Countable Resources

The following resources are countable for the LIS:

1. Liquid assets; and

2. Real property other than the homesite and contiguous property. Life estate, tenancy-in-common and remainder interests are countable for the LIS.

To determine the value of a tenancy-in-common interest:

a. Verify the number of owners and the equity value (market value minus any encumbrances) of the property;

b. Divide the equity value of the property by the number of owners. This is the countable value of the tenancy-in-common interest to be included in resources for the LIS.

3. Always use the equity value of resources in determining eligibility.

C. Non-Countable Resources

The following resources are excluded in determining eligibility for the LIS:

1. Personal property such as household goods, vehicles, boats, motorcycles, non-cash business property, and personal effects.

2. Cash value of life insurance owned by an individual when the total face value of all the life insurance policies owned on any person does not exceed $1,500.00.

NOTE: This is different from the Medicaid program which does not count cash value unless the total face value exceeds $10,000.

3. Funds up to $1,500 for the individual and $1,500 for the spouse who lives with the individual if the funds are intended to be used for funeral or burial expenses. The client may have other non-countable burial resources.

4. Dedicated financial institution accounts consisting of past-due benefits for an SSI-eligible individual under age 18.

5. All Federal and State tax refunds (exclude for 12 calendar months beginning the month of receipt.

REISSUED 03/01/12 – CHANGE NO. 05-12

(V)

D. Determine Countable Reserve

1. Use the equity value of resources. Follow procedures in MA-2301, Conducting a Face-to-Face Interview, MA-2303, Verification Requirements for Applications, and MA-2304, Processing the Application, for verification requirements, requesting information and time frames.

2. Apply any exclusions shown in V. C. above or in MA-2230, Financial Resources.

3. The remainder is countable reserve for the applicant.

E. Resource Limit

1. The maximum resource limit for the subsidy is $11,570 for one person and $23,120 for a couple. The couple limit applies as long as the applicant and the spouse are living in the home, regardless of whether one or both apply.

2. Resources at or below $6,940 for one person and $10,410 for a couple entitle the applicant to the full subsidy and co-payments for prescriptions if income is equal to or less than 135% of the federal poverty level.

If the reserve is above $6,940/$11,570 but at or below the $10,410/$23,120 limit, the individual may be responsible for 15% co-payment until the total drug costs reach the catastrophic coverage limit. Once this limit is reached there will be a co-pay per prescription.