DATE: OCTOBER 29, 2007
Manual: Aged, Blind, and Disabled Medicaid
Change No: 25-07
To: County Directors of Social Services
Effective: November 1, 2007
The Deficit Reduction Act of 2005 (DRA) became law effective February 8, 2006. The DRA amended section 1917 of the Social Security Act (the Act) to make several changes concerning resources and transfers. Refer to Change Notice 24-07, MA-2240, Transfer of Assets, MA-2241, Transition Policy for In-Home Health Services & Supplies, MA-2242, Home Equity Value & Eligibility For Institutional Services, and MA-2245, Undue Hardship Waiver For Transfer Of Assets.
Which is currently used (or during the lookback period was used) as his principal place of residence, or to which he intends (or intended) to return, or
Which is currently used (or during the lookback period was used), as the principal place of residence of his spouse or his dependent relative. It includes the land the home sits on and all buildings and land contiguous to the home.
PCS services provided to individuals in an ACH are not subject to this policy. Refer to MA-2240, Transfer of Assets.
The following are not resources in determining Medicaid eligibility:
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.
The Social Security Act authorizes the exclusion of income and 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).
Follow these procedures for the quota owners:
Every year Medicare makes a deposit into an interest-bearing account to help the plan member cover their health care costs until the deductible is met. Therefore, the account funds are countable as a resource.
EXAMPLES: Perkins Loans; Stafford Loans such as the National Direct (Defense) Loan; Federal Supplemental Educational Opportunity Grant (FSEOG); Pell Grants, College Work-Study Programs including PACE, NC Student Incentives Grants; Upward Bound; etc.
North Carolina’s Medicaid Program is named as a remainder beneficiary in the first position. If there is a community spouse and/or any child or children under age 21, or a disabled child or children of any age, when the purchase/change takes place North Carolina’s Medicaid Program may be named in the next position after those individuals. This applies to the a/r and the a/r’s spouse.
Note: The amount that the State of North Carolina Medicaid Program can receive, as a beneficiary of a Medicaid recipient’s annuities, is limited to the amount that Medicaid paid on behalf of the Medicaid recipient.
Refers the caseworker to MA-2240, Transfer of Assets, to determine when the CAP indicator is entered for CAP applicants/recipients subject to a deductible and a sanction period.
This policy is effective November 1, 2007. Apply this policy at each redetermination started on or after November 1, 2007, and each application taken on or after November 1, 2007. This change notice obsoletes DMA Administrative Letter Number 34-87.
Insert: Table of Contents, pages 1-3 revised 11/01/07.
Insert: MA-200, Definitions, pages 1-33 dated 11/01/07.
Insert: MA-2303, Verification Requirements For Applications, pages 1-8 and
Insert: MA-2304, Processing The Application, pages 3-14 dated 11/01/07.
Insert: MA-2360, Medicaid Deductible, pages 1 and 2 dated 11/01/07.
If you have any questions regarding this information, please contact your Medicaid Program Representative.
William W. Lawrence, Jr., M.D.
(This material was researched and written by Sandi Morrow, Policy Consultant Medicaid Eligibility Unit.)
For questions or clarification on any of the policy contained in these manuals, please contact your local county office.