Medicaid Policy
Medicaid Policy
ABD, MWI and Long-Term Care
COUNT a retirement fund owned by an individual or any eligible family member if they have the option of withdrawing the fund as a lump sum. If the only access a person has is to petition the account or plan manager for the funds under a "hardship" or "emergency" clause of the plan, the funds are not available until they are received by the individual. Do not require the individual to petition for release of the funds.
DO NOT COUNT money in a retirement fund if the individual or family member must terminate employment to obtain any payment.
If the individual has a choice between periodic payments and a lump sum, the fund is exempt as an asset in the form of the periodic payment. However, the individual must apply to receive such payments. If the individual receives monthly payments, the fund is an excluded asset and the payments are treated as countable income.
An eligible family member is either a spouse of the individual, a parent of a minor individual, or a spouse of a parent of a minor individual, who is also Aged, Blind, or Disabled, whether or not that family member is on, or is applying for, Medicaid.
COUNT money held in a retirement fund under a plan administered by an employer or union, an individual retirement account (IRA), or KEOGH account owned by a spouse FOR THE ASSESSMENT OF ASSETS only if it is available. Consider it available even if a penalty must be paid to access the money.
DO NOT COUNT a retirement fund/pension fund owned by an ineligible spouse, ineligible parent or ineligible spouse of a parent. This includes any retirement fund under a plan administered by an employer or union, an IRA or KEOGH account. An ineligible spouse, parent or spouse of a parent is someone who is not Aged, Blind or Disabled.
For the Medicaid Work Incentive Program do not count any retirement fund owned by the individual. This includes any retirement fund under a plan administered by an employer or union, IRA’s, KEOGH accounts or 401(k)’s. Do not count these assets towards the $15,000 asset limit. Continue to exempt these assets for the lifetime of the individual when determining aged, blind or disabled Medicaid eligibility for the individual when:
The individual was on MWI for at least one month; and
The assets were excluded while the individual was on MWI.
Pension funds divided by a QDRO (Qualified Domestic Relations Order). Count the value of an individual’s right to benefits under a pension or retirement benefit plan that has been divided by a QDRO if the individual has the right to withdraw the funds and is not receiving periodic payments. If the individual has the option of receiving periodic payments, the individual must apply for such payments. (See 1.B) Do not count the portion of the pension or retirement plan that has been awarded to another individual. See 415-3 for a definition of QDRO.
A previously unavailable retirement fund is not income to the recipient when the fund becomes available. The fund is subject to be counted as a resource in the month following the month in which it first becomes available. However, if it is accessed in the form of a periodic payment and the fund continues to be unavailable, the payments are considered income when received.
Medically Needy Family, Child, and Pregnant Woman
Any available pension funds must be counted as assets towards the asset limit unless they belong to a disabled parent who is not included in the Family Medicaid coverage.
Available pension funds that belong to a disabled parent who is not included in the Family Medicaid coverage are exempt.
If a pension fund has been divided by a QDRO (Qualified Domestic Relations Order), count only the portion available to the individual. See sec. 415-3 for a definition of QDRO.
Treat funds in the following manner.
If the individual has the option of receiving periodic payments from a pension or retirement fund, the individual must apply to receive such payments. If the individual receives monthly payments, the fund is an excluded asset and the payments are treated as countable income.
Do not count a pension fund if an individual must terminate employment to access the pension fund.
Non-available pension funds are exempt (511).