Medicaid Policy
Medicaid Policy
Exclude an individual's home, regardless of value, if it is the individual's principal place of residence. Exclude ONLY one home for a married couple or a single individual.
An individual's home is property in which he or she has an ownership or life estate interest, that serves as his or her principal place of residence and to which, if absent, he or she intends to return. It can be real or personal property, fixed or mobile, and located on land or water. For purposes of excluding the real property on which the shelter is located, it is not necessary that the individual own the shelter itself.
(See 553 if a individual owns a life estate in property other than the individual's principal residence.)
For Aged, Blind, Disabled, an excluded home includes:
The shelter in which he or she lives;
The contiguous real property on which the shelter is located; and
Related buildings on such land.
See the definition for contiguous property in #I below.
Excluded Home for Medically Needy Pregnant Woman, Family and Child Medicaid Programs.
Exclude one home, including a mobile home, and lot owned or being purchased and occupied by the individual. The lot on which the home stands must not exceed the average size of residential lots in the community where it is. Count the equity value of property exceeding an average size lot.
Exempt a life estate in a home if the owner of the life estate continues to live in the home. (See 553 if a individual owns a life estate in property other than the individual's principal residence.)
If the individual does not live in the home or life estate that was the individual's principal residence or the individual becomes a resident of a medical institution, the home or life estate may be a countable resource. Decide if the individual intends to return to the home.
The home can be excluded from resources if the individual intends to return to live in the home and the home is located in Utah. The individual or his representative must state the intention in writing. There is no time limit to this exclusion; however, if the individual's intent changes and he no longer intends to return to the home, this exemption ends and the home may be a countable resource.
If the individual does not intend to return to the home, the home is a countable resource unless one of the exceptions in E. apply. If the home is located in another state, and the individual intends to return to the home, the home is excluded but the individual is not a Utah resident. If the individual has made conflicting statements about his or her intent to return to an out-of-state home, the individual must present a written statement of intent.
Exceptions - When to Exclude the Home and Lot, When the Individual Does Not Live In It
If the individual does not intend to return to his or her home, it can be excluded if the following conditions apply.
Undue Hardship for a Co-Owner
If the property is jointly owned, evaluate whether its sale would cause undue hardship, due to loss of housing, to a co-owner. If undue hardship is met, the home may be excluded. Undue hardship would result if the co-owner:
Uses the property as his or her principal place of residence, AND
Would have to move if the property were sold, AND
Has no other readily available housing.
No other readily available housing means that there is either no housing that would be affordable for the individual, or there is no other readily available housing with necessary physical modifications that would accommodate the individual’s disabilities, or other similar reasons. It does not simply mean that the person does not want to move or that it would be inconvenient to move.
Additional Exceptions for Institutional Individuals
A home or life estate that was the individual's primary place of residence prior to institutionalization can be excluded if the following criteria are met. These apply ONLY to a home, including the lot and contiguous property that was the individual's primary place of residence before becoming institutionalized.
Short Term Stay. Do not count the home or lot as a resource if a doctor says the individual is likely to return home within 6 months of admission to the medical institution. Anyone in an institution more than 6 months after admission is long term and this exclusion no longer applies; OR
Reliant Relative lives in the Home. The home and contiguous property is excluded only while the home is occupied by the individual's spouse or reliant relative. If the relative moves out of the home, the home becomes countable.
Reliant relatives are any relatives who claim to rely upon the individual for financial help, medical help, or any other reason.
Relatives include any of the following: child, stepchild, grandchild, parent, stepparent, in-laws, siblings, half-siblings, step-siblings, grandparent, aunt, uncle, nephew, niece, cousin.
The home can be in Utah or another state if a reliant relative lives in it.
Substantial Home Equity. An individual applying for or receiving nursing home or waiver services under Medicaid is not eligible for those services when the equity the individual has in his or her home exceeds the substantial home equity limit (Table II-A). Certain exceptions apply. See 575-3 for Substantial Home Equity rules.
If an individual applying for or receiving nursing home or waiver services purchases a life estate in someone else's home, the purchase may be treated as a transfer of assets for less than fair market value. See 575-1 for policy on Life Estate purchases. An individual who sells their own home retaining only a life estate may also have transferred assets for less than fair market value. See 575 forward for transfer of asset policy.
Contiguous Property
If the home is excluded under this policy, do not count the lot that the home sits on. Also exclude all contiguous property. Contiguous property is all property owned by the individual that is not separated from the individual's residence by property belonging to another person. It is contiguous if the only separation from the home is a river, road, or public right of way. Contiguous property includes lots and the buildings on the lots.