Family and Children's Medicaid MA-3320 RESOURCES

IV. WHAT RESOURCES ARE COUNTED

To determine what resources are counted toward the $3,000 resource limit, use the chart below. Where additional information is needed to evaluate the resource, the appropriate part of the section is referenced in the chart.

RESOURCE	DO NOT COUNT	COUNT	VERIFICATION
Accident Insurance with Death Benefit	X
Bank Accounts		X	See A.
Boats, boat trailers, boat motors (not income producing)		X	A/R’s Statement unless questionable
Burial contracts (preneed)	X
Burial Insurance Policies	X
Campers not used as a homesite (not income producing)		X	A/R’s Statement unless questionable See B.
Cash on Hand		X	A/R’s statement
Farm or Business Equipment (not income producing)		X	A/R’s Statement unless questionable See B.
Funds received from Walker v. Bayer	X
Income-producing personal property, business or farm equipment	X
Investments, such as Savings Bonds, mutual funds, and stocks See C.		X	View savings bonds, stock certificates, business records or other records
Life Insurance	X

Loans/Promissory Notes	See E.	See E.	See E.
Lump Sum See D. See MA-3300 (for income instructions)	Month of receipt	Remainder in subsequent months	View check or award letter Contact provider
All Federal and State tax refunds, Including Child Tax Credit (CTC) and Earned Income Tax Credit (EITC)	Do not count for 12 calendar months beginning the month the refund is received.	Remainder in subsequent months	View check or award letter Contact provider
Motor vehicles (Also see Personal Property below)	X
Patient Accounts in Long-Term Care Facilities		X	Contact facility
Personal effects and household goods	X
Personal Property such as mobile home or motor home used as a home site, or recreational vehicle used as primary mode of transportation.	X
Personal Property such as mobile home or motor home not used as a homesite or recreational vehicle not used as primary mode of transportation which are not income producing.		X	A/R’s Statement unless questionable See B.
Real Property	X
Relocation Assistance Payments (Title XX of Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970)	X
Resulting Trusts/Legally Binding Agreements	See G.	See G.	See G.
Retirement Accounts	X		See F.
Sale of an Asset		Month after receipt of funds	A/R’s Statement
Sponsor Deeming		X	See MA- 3313
Stocks and Mutual Funds, including stock owned by an individual in his/her own C-Corporation		X	View stock certificates, business records or other records
Trust Funds	X
Utility Trailers (not income producing)		X	A/R’s Statement unless questionable See B.

A. Bank Accounts (Checking, Savings, Credit Unions, Savings & Loans, Certificate of Deposit (CD), Direct Express Debit Cards, NCKIDSCARE Card, Medicare Health Savings Account, money market, life insurance accounts or dividends that accumulate in an account at the company, etc., as well as any item that can be converted to cash (i.e. cash value bearing life insurance policy).

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(IV.A.)

1. If the a/r or b.u. member claims a resource should not be countable to him because of a resulting trust/legally binding agreement, see G. below, Resulting Trusts/Legally Binding Agreements.

2. Do not count as a resource the amount of income deposited in bank accounts to pay monthly bills or a lump sum from self-employment deposited to pay annual expenses. Accept the a/r’s statement as verification.

3. Verify the current balance by:

a. Seeing the last account statement, or

b. Using the DSS-3431, “Request for Financial Information.”

Explain to the a/r that for the DSS-3431, “Request for Financial Information,”

(1) He has the right not to give consent;

(2) Once consent is given, it may not be revoked;

(3) The consent is valid for a period not to exceed twelve months; and

(4) Giving consent is not a condition of doing business with any financial institution.

c. Financial institutions cannot provide information on joint accounts without the consent of all account holders. It is the responsibility of the a/r to obtain consent from all the joint owners.

d. Explain to the a/r that refusal to give consent will result in denial or termination of benefits for failure to cooperate in establishing eligibility.

e. Verify the balance of an EBT account through the North Carolina EBT Production System that is located in each county.

B. Personal Property

1. Verifying Ownership

If you are unable to verify the personal property through the online verification system and the a/r’ statement is questionable, check the names of the adult members of the b.u. against county property tax records, review bills of sale, titles, insurance policies, finance records, etc.

2. Exclude income-producing personal property.

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(IV.B.)

a. Ask the a/r to provide documentation of how the personal property is used to produce an income to the b.u.

b. Deduct the expenses of ownership of the property and expenses involved in producing the income from the payment received for use of the property. Refer to MA-3300, Income, X. (Self-Employment Income) for treatment of allowable transportation expenses.

c. The property is income-producing if, after deducting expenses, there is any adjusted gross income remaining, regardless of the amount.

3. Exclude personal property that is being used as the a/r’s homesite, such as a mobile home, camper or motor home.

4. Exclude personal property that is being used as the a/r, or financially responsible person’s primary mode of transportation. Examples are, but not limited to, motorcycles, boats, and mopeds. Personal property such as dirt bikes, four wheelers, etc. which cannot legally be licensed for transportation would not qualify for this exemption.

5. Determining the Equity Value

a. Equity is the Current Market Value (CMV) less any encumbrances (“pay-off amount”).

b. Determine CMV by using local property tax records or DOT/DMV for licensed personal property, such as mobile homes, trailers, etc. Reviewing bills of sale, or finance records. Contact retailers of the personal property item to determine a value.

C. Stocks In A Private Corporation

1. If the a/r owns stock in a closely held corporation which is not listed on the stock market, determine the value of the stock as follows. This generally pertains to assets of self-employed individuals who own their own business.

a. Determine the equity value of all assets owned by the corporation, including real and personal property, vehicles and liquid assets. The equity is the value of each asset less any encumbrances on that asset.

b. Divide the total value among all stockholders based on each stockholders percentage of ownership, as established by the Articles of Incorporation.

c. The value of the stock is a countable asset to the a/r.

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(IV.C.)

Example: A-1 Paint Store is owned by the a/r and his two nephews. The business is incorporated and the a/r owns 60% of the stock. The corporation owns the land and the building in which the store is located. The tax value is $150,000 and the outstanding mortgage is $105,000, with an equity of $45,000. The business also owns a van valued at $7,500 on which they still owe $5,000, with an equity of $2,500. There is a corporate bank account with a balance of $1,250. The total equity in assets is $48,750. The value of the a/r’s stock is $29,250.

d. Any assets owned by and in the name of the corporation are considered in the determination of the value of the stock and are not countable as a separate asset to the a/r.

e. Count stock value or self employed ownership interest in a corporation as a resource.

2. If the documents are held by another party for the b.u. member, contact the other party for verification.

3. Record the value verified, how verified, and the date verified on the base document.

D. Lump Sums

1. If an a/r states that the lump sum payment has been spent:

a. Ask the a/r to produce receipts to show how the money was spent or

b. If there are no receipts, accept the a/r’s written statement.

E. Loans/Promissory Notes

1. If the a/r or b.u. member is the borrower:

a. Do not count a loan as a resource in the month of receipt if there is an agreement to repay.

b. Count any remaining funds in subsequent month.

2. If the a/r or b.u. member is the lender:

a. Do not count the value of a promissory note or the payments received from a loan or promissory note.

b. Count the payments as income. Refer to MA-3300, Income

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(IV.)

F. Retirement Accounts

1. A formal plan, recognized by federal tax law, intended to provide income when an individual ceases working. Examples: IRA, 401(k), Simplified Employee Pension (SEP), Tax Sheltered Annuity (TSA or 403(b)), Savings Incentive Match Plan for Employees (SIMPLE) Keough (usually for self-employed workers, also called HR-10), and company sponsored retirement plans

2. If an individual withdraws the retirement funds in a lump sum, it becomes a countable asset when it is received by him. Verify by using the following methods:

a. The a/r provides documentation from the administrator of the retirement fund or the financial institution which verifies the total value of the account prior to withdrawal, the deductions taken prior to disbursement, the total amount refunded to the a/r or financially responsible person and the date of the transaction.

b. Contact the administrator of the retirement fund or the financial institution. Document in the record the total value of the account prior to withdrawal, the deductions taken prior to disbursement, the total amount refunded to the a/r or financially responsible person and the date of the transaction.

G. Resulting Trusts/Legally Binding Agreements

1. Policy Rules

a. It is presumed that a resource owned by an individual is also countable for him, unless there are circumstances which make the resource of no benefit to him because he is holding the resource for someone else.

b. The terms of a separation agreement, divorce decree, will, deed, order, resulting trust or legally binding agreement may cause a resource technically owned by an individual to be of no benefit to him.

c. A resulting trust exists when a person has a resource in his own name but is holding it for the benefit of another person and he:

(1) Retains no legal interest in the resource, and

(2) Will not benefit from the disposal of the resource.

d. If the a/r or b.u. member alleging that a resource is held in trust for someone else continues to retain a legal interest in the resource and/or will receive the proceeds from the disposal of the resource, it is not considered to be held in trust for someone else and is a countable resource.

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(IV.G.1.)

e. If the a/r or b.u. member claims a resource should not be countable to him because of a resulting trust/legally binding agreement, he must cooperate by presenting necessary supporting documentary evidence.

f. A legally binding agreement may be either a written or a verbal contract. The evidence must be sufficient to:

(1) Convince others of the validity of the agreement,

(2) Show that the agreement existed at the time of the purchase/deposit of the resource, and

(3) Show that the legal title holder holds the resource/property in trust for the other party who is making payments or deposits.

2. Verification

When a resource is owned by an individual who has applied for Medicaid, determine whether it may not be countable to him because of a legally binding agreement or resulting trust.

a. Written Contract:

(1) Review the contract and determine if it affects whether the resource is countable to the a/r.

(2) Determine the intent and terms of the agreement between parties, including the type of resource, the date of the contract, reason for its existence, and specific terms of the agreement.

(3) Contact the county or agency attorney if there are questions regarding the terms or validity of the written contract.

b. Verbal Contract/Agreement:

Ask the a/r to submit 2 different types of the following evidence:

(1) Written statement(s)/affidavit(s) from the parties involved in the verbal agreement:

(a) Giving the type of resource,

(b) The intent and terms of the agreement, and

(c) Describing the involvement of the parties to the agreement.

(2) Cancelled checks or receipts for payments on a loan showing who is making payments on the resource,

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(IV.G.2.b.)

(3) Letter(s) or statement(s) from finance companies, banks, loan officers, credit unions, automobile salespersons, insurance companies or agents, or others identifying the type of resource and supporting claims that the resource is held for another individual who is making payments on the resource, or

(4) Written statements from at least 2 knowledgeable persons:

(a) Identifying the type of resource, and

(b) Giving the circumstances surrounding ownership, and

(c) Who benefits from the resource and the basis for their knowledge.