Medicaid Policy
Medicaid Policy
Previous Policy (421-3 was previously found in section 407-3 until November 1, 2021)
A. All Programs
1. Count the net lump sum payment as income for the month it is received if it is not excluded in 421-2.
2. Any amount remaining after the end of that month is considered an asset for programs that have an asset test.
3. Notice requirements for a change to eligibility apply. See section 811 for notice policy.
Note: Remember that some types of lump sum payments may have a special period of time that they are excluded from resources (See 531, or specific asset policy in 521.)
B. MAGI-Based Programs
1. Count the net lump sum payment as income only for the month it is received.
· This could be during a retroactive month or the application month.
2. The individual might report a lump sum for the first month of the new certification period (if the date and amount of the lump sum is known.)
3. Do not prorate the lump sum payment over the certification period when determining the MAGI-based income for the upcoming certification period.
4. Notice requirements apply for a change to eligibility. See section 811.
C. Long-term Care
1. Lump sum payments are included in Total Income of individuals in a medical institution or receiving HCB waiver services in the month received.
2. These rules also apply for nursing home residents. See section 811 for policy about notices if the lump sum results in a case closure or increase in contribution to cost of care.
D. Overpayments
If the lump sum payment caused an overpayment or understated liability, see section 825.