Medicaid Policy
Medicaid Policy
Previous Policy (373-6 renumbered to 573-6 as of November 1, 2017)
Initial Application
At the initial application, once eligibility is established for a member with a community spouse, determine if the member has ownership or joint ownership of assets that are included in the community spouse's protected share of resources.
If the institutionalized spouse is the owner or joint owner of assets totaling more than $2000, those excess assets must either be used for the member or spouse's benefit or transferred to the community spouse. This would be the assets included in the community spouse's protected share.
The amount of the member's share of assets disregarded at application because the member received benefits under a long-term care insurance partnership policy do not have to be used, or transferred to the community spouse. They continue to be disregarded from the member's countable assets. (See 513)
The member has until the next review (721) to use any excess assets for the benefit of the member or the member's spouse, or to transfer ownership of the excess assets to the community spouse.
The member can transfer assets up to the community spouse's protected share as determined at the time eligibility is established (573-2).
The institutionalized spouse is asset eligible for Medicaid pending the transfer of the assets until the end of the review month.
Do not assess a penalty for transfers to the community spouse.
If the institutionalized spouse owns more than $2000 after the end of the review month, the institutionalized spouse is ineligible unless the couple can prove they could not transfer the assets by the end of the review month.
If the couple proves they could not transfer the assets by the end of the review month, allow a reasonable time extension to transfer the assets.
If the member does not transfer the asset by the end of the review month or within the time extension, close the case and process an overpayment for the period of time Medicaid has been approved (825).
Application After a Break In Coverage
If a member's Medicaid closes and the individual later reapplies, the agency may need to redetermine the spouse's protected share of assets.
Redetermine a new protected share if the member will have a period of at least one calendar month with no eligibility (573-2).
Do not redetermine a new protected share if eligibility will go back to the previous closure date and no break in coverage will occur.
If the agency redetermines a new protected share of resources for the community spouse and the member owns assets in excess of $2000, the member receives a new protected period to use or transfer assets as described in A.