Medicaid Policy                                                                 

503-1 Whose Assets to Count

Effective Date: January 1, 2018

Previous Policy

 

Aged, Blind, and Disabled Programs

 1.  The Individual

  For all coverage groups of Aged, Blind, or Disabled Medicaid, this is the aged, blind, or disabled person.  For QMB, SLMB, QI, and the Qualified Working Disabled, this is the Medicare recipient.

 2.  For an Unemancipated Child

      Count a portion of all the assets of any parents in the home, even if the child receives SSI.  Also count the parents' assets while the parents or child are temporarily out of the home for schooling, medical care, visits, etc. 

1. To determine the amount of parents’ assets to deem to the disabled child, first apply the rules for excluded assets to the parents’ assets.

2. Deduct an allowance for each parent in the home from their total countable resources.  $2000 for one parent living in the home; $3000 for two parents. 

3. Determine the child's countable assets by first applying the rules for excluded assets.  Then add the value of the parents remaining assets to the disabled child's countable assets.  When there are two or more disabled children, divide the deemed assets equally between them.  Compare the countable assets to the asset limit.

4. Children in any type of boarding school are temporarily absent. 

5. If an absence is not temporary, stop counting the assets of the parents the month after the child or parents left the home (215-2).

[See the glossary for a definition on emancipation]

 3.  Spouse

1. If the spouse is living with the individual, add the spouse's assets to the disabled person's assets.  If the individual receives SSI, you must still count assets from the spouse. To be eligible, the total assets must not exceed the asset limit for two people.  For the Medicaid Work Incentive Program, there is one asset limit regardless of the number of people in the household (See Sec. 503). If one spouse is on a waiver program, refer to D. below.

2. If the individual is separated, do not count the spouse's assets, beginning the month after the separation, as long as the reason for the absence is not temporary.  (Joint assets that are still available to the individual would need to be separated if they cause the individual to exceed the asset limit.  If the individual claims joint assets are not available, refer to policy in Sec. 511.)

3. Do not count the assets held in the name of a spouse who is a resident of a medical institution or who is eligible for nursing home Medicaid. 

4. For Medicaid programs, do not count the assets of a spouse who receives Medicaid under a HCB waiver program if those assets are separate from the non-waiver spouse’s assets.  If the assets of the waiver spouse and the non-waiver spouse are not separate, divide them equally between them.  If the total resources do not exceed $4000, then each spouse will meet the $2000 resource limit.  For QMB, SLMB, and QI, count the assets of both spouses when they live together, even if one or both are eligible under a waiver.

 

Medicare Cost Sharing Programs

For QMB, SLMB, QI, or QDWI, count the assets of both spouses when they live together, even if one or both are eligible under a waiver. 

 

Family, Child and Pregnant Woman Medically Needy Programs

Household Size and Proper Deeming

Count assets of the individual, the individual's spouse, and the parents or stepparents of a minor individual.

Policy prohibits sibling to sibling deeming of income and assets.

All children, as applicable, are counted in the household size along with their parent(s).

For the child's Medically Needy program the income and assets of a child and their parent(s) is compared to the income limit using the full household size.  The assets of a sibling are not counted to determine the child's eligibility.

Determine each child’s asset eligibility separately.

Policy prohibits child to parent deeming of income and assets.

To determine the parent's eligibility, count all children meeting the dependent child criteria and living with the parents in the household size along with their parent(s).

Do not count the income and assets of a child of a parent or caretaker relative for Family Medically Needy.

Do not count the income and assets of a child of the pregnant woman for the Pregnant Woman Medically Needy program.

The Family Medically Needy program requires that a deprived age-eligible child be present in the parent's or parent caretaker relative's household. However, the child does not need to be eligible or applying for Medicaid coverage (345-2).  

Additional Asset Information

Do not count assets that remain in a refugee's homeland if they are not available to the individual.  Accept the client's statement that they are not available, unless you have contradictory evidence.

Do not count the assets of any parent or caretaker relative who receives SSI or has 1619-B status.  They should be included in the household size.

Long-term Care Programs

Nursing Home Resident

Count the assets that belong to the individual.  

If the resident is an unemancipated child, count the parents assets for the month of entry and the month of exit only.

If a newborn child is born in a hospital, meets disability criteria and must remain in the hospital for an extended period, do not count the parent's assets to determine the newborn's eligibility.

If the individual is married, count the amount of assets attributed to the institutionalized spouse according to the assessment of assets.

DO NOT count the income or assets of the individual's spouse after eligibility has been established for the institutionalized spouse.  Assets that are jointly held at the time of the assessment may need to be separated after eligibility is established.  Determine if the jointly held assets would make the nursing home resident exceed the resource limit in the month after eligibility begins.  If so, advise the applicant and spouse of the need to separate those assets (573-6). 

Home and Community Based Waiver Member

Count the assets that belong to the individual.

DO NOT count the assets of parents of an unemancipated child beginning with the first month of waiver eligibility.

DO NOT count the assets attributed to a spouse who is living with the waiver-eligible spouse as determined in the assessment of assets, according to the spousal protected period rules found in sections 573-6. 

DO NOT count the assets of a spouse who is a resident of a medical institution or who is eligible for nursing home Medicaid.  The couple may have to separate jointly held assets before eligibility can be approved.

If both spouses are eligible for a HCB waiver program, divide jointly-held assets equally between them. Count assets held only in one spouse’s name to that spouse.

 

Sponsors of Non-citizens

Do not deem a sponsor's assets to a resident non-citizen.  When deeming income from a non-citizen's sponsor (425-2), asset deeming is inherent in the income calculation to decide how much income to deem from the sponsor.  This is because assets of a sponsor are used only if the sponsor needs to count them to meet the sponsorship income limit required by USCIS.

 

When the sponsor is the non-citizen's spouse or parent of a minor non-citizen child who is living with the sponsored non-citizen, deem assets the same way you would from any spouse or parent.  Do not use sponsor deeming rules.

 

Note: Assets of a non-qualified non-citizen spouse or parent must still be counted if that spouse or parent is living with the individual, or is temporarily absent.