Medicaid Policy
Medicaid Policy
Previous Policy (421-2 was previously found in section 407-2 until November 1, 2021)
Exempt Lump Sum Payments
Some kinds of lump sum payments are exempt as income. Exempt lump sum payments include:
1. Any kind of lump sum payment of excluded earned or unearned income.
a. If that kind of income is excluded, the lump sum payment is also excluded. (See 421 and 417.)
b. For institutionalized members on long-term care, lump sum payments consisting of only the $30 SSI payment, or the VA $90 payment are exempt income and do not count as a lump sum payment.
c. If the lump sum payment is for back $30 SSI payments plus other back payments, the other back payments for the first full month of institutionalization plus the following month are exempt.
2. Insurance settlements for destroyed exempt property. (See 415-9 and 551.)
3. Lump sum payments consisting of SSI payments for prior months except that SSI is not exempt for institutional/waiver members so lump sum payments are not exempt either. The exception to this is in #1 above. (See 417-17, 521-30, and 531.)
4. For MAGI-based eligibility groups, Veteran's benefits and child support payments are not countable income.
· Any lump sum payment consisting of VA or child support payments are not counted as income for the MAGI-based eligibility groups.
5. SSA or Utah Department of Health and Human Services reimbursements of Medicare premiums the member had paid.
6. Death benefits to the extent the funds are used for the expenses of the deceased person's last illness, funeral and burial.
· Death benefits that are not used for the last illness, funeral and burial count as income. (See sec. 417-6 and 531-4)
7. Money received from a TPL source for medical expenses, IF the money will be recouped by ORS.
· Any amount that will not be recouped by ORS and will be paid to or made available to the individual is not exempt and must be counted as income in the month received. (415-12)
8. Count as income all lump sum payments that are not listed above. (For information about money received under a contract. see Sec. 435-2 and 415-8.)