Medicaid Policy
Medicaid Policy
Declaration of Assets
1. An applicant who does not qualify for a MAGI based program, or who requests eligibility on some other basis, must declare what assets the household has and the value of those assets. This may be done at application, but is not required as the agency will first evaluate for a MAGI-based coverage group.
2. If the individual is not eligible for a MAGI-based coverage group, but may qualify on another basis, request asset information if not previously provided. Prior to requesting hard copy verification, consider if the applicant's stated assests are reasonabily compatible with electronic sources.
3. A recipient on a program with an asset test must report changes in assets and their value within ten days of a change and at review.
Review section 731 et al, to determine how to verify assets. Some assets cannot be verified using client statement.
First Moment of the Month Rule
1. Use assets held on the first moment of a calendar month to determine eligibility for that month for:
· Aged, Blind and Disabled Medicaid programs
· Medicare Cost-Sharing programs
· Long-term care, both institutional and waiver
2. If the individual's assets exceed the asset limit, carefully examine the account balances. Deduct the amount of pending account transactions from the balance on the first moment of the month, if they have not been deducted from the individual's account balance already. Payments that clear the bank on or near the first day of the month may have been made before the first of the month. Ask your individual if such payments were made before the first. Also, do not count any income for the month in the balance.
3. The case is ineligible for the entire month if countable assets exceed the limit on the first moment of the month.
Counting Assets for Family, Child and Pregnant Woman Medically Needy Individuals
1. Use assets held at any time during the month to determine eligibility for medically needy Family, Child, or Pregnant Woman Medicaid.
2. Use the lowest balance during the month to decide if assets are below the asset limit. Do not count income for the month in the balance.
Special asset rules
1. Do not count anything as an asset if it is being counted as income in that month, except as defined in 512, relating to trusts.
2. If an individual does not have a burial plan or life insurance, and is over the asset limit, ask if he has any funds set aside for burial (592).