Medicaid Policy
Medicaid Policy
Contact DHHS Policy Specialist for Previous Policy (371-4 was renumbered to 575-4 as of November 1, 2017)
Do not apply transfer of asset policies to New Choices Waiver Community Medicaid coverage groups or New Choice Waiver Spenddown coverage group (386-3).
Do not restrict Medicaid services when the assets or income that were transferred for less than fair market value meet the following criteria.
Transfer of a home
A home is transferred to the spouse.
A home is transferred to a blind or disabled son or daughter.
A home is transferred to a son or daughter under 21 years of age.
A home is transferred to a son or a daughter who has:
Lived in the home, AND
Provided care to the individual which allowed the individual to remain at home rather than be institutionalized (doctor's statement required) , AND
Has done so for at least 2 years immediately before the date the individual entered the medical institution. Request evidence of residency.
A home is transferred to a sibling who has an equity interest in the home and who has lived in the home for at least 1 year immediately preceding the individual's entry into a medical institution.
Estate Recovery may still apply to the transferred asset (835).
Transfer of an asset
An asset or income is transferred to the spouse.
An asset or income is transferred to a blind or disabled son or daughter.
Transfer for the Sole Benefit of
The individual’s assets or income are transferred to another for the sole benefit of the spouse. (In the case of an annuity, see 575-1.)
The spouse’s assets or income are transferred to another for the sole benefit of the spouse. (In the case of an annuity, see 575-1.)
Assets or income are transferred to a trust established for the sole benefit of a blind or disabled son or daughter (575-5).
Assets or income are transferred to a trust established for the sole benefit of an individual who is blind or disabled and who is under age 65 (575-5).
Transfer of Excluded Assets
The home is not an excluded asset for an institutionalized person. A penalty applies for the transfer of a home that does not meet one of the above criteria.
Do not apply a transfer penalty to the transfer of assets listed below:
Household goods, personal effects as identified in 521-3.
An automobile as identified in 521-4.
The value of any burial space as identified in 591.
Property that is essential to self-support as identified in 521-8.
A plan for achieving self-support ((PASS) as identified in 521-20.
Certain Stock in Alaska Regional or Village Corporations. If you have an individual who claims to have stock in or received from an Alaskan Regional or Village Corporation, contact the Program Specialist. The specialist will work with the Seattle Regional Office to determine how to treat such resources.
Federal Disaster Relief and Emergency Assistance as identified in 521-31 but only for the 9-month period beginning on the date such funds are received (or for a longer period where good cause is shown by the individual concerned for extending such period).
Any amount received by a person from SSI or SSDI consisting of underpayments of benefits that are due for one or more prior months. This exclusion is limited to the first 9 months following the month in which such amount is received.
Assistance paid, with respect to the dwelling unit occupied by such individual (or such individual and spouse), under the United States Housing Act of 1937, the National Housing Act , section 101 of the Housing and Urban Development Act of 1965, title V of the Housing Act of 1949, or section 202(h) of the Housing Act of 1959.
Any amount received from a fund established by a State to aid victims of crime for the 9-month period beginning after the month it is received as identified in 521-26.
Relocation Assistance Payments. Relocation assistance provided by a State or local government for the 9-month period beginning after the month it is received as identified in 521-27.
After December 31, 2012, for the 9-month period beginning after the month it is received, any amount of a federal tax credit made to an individual (or spouse) consisting of a child tax credit, or earned income tax credit.
Any account including accrued interest or other earnings established and maintained as a protected account for an SSI child (521-30).
Any gift to or for the benefit of an individual who is not yet 18 years of age and who has a life-threatening condition if it meets the criteria of 521-36.
Any amount a person receives from SSI, SSDI, or Special Benefits for Certain World War II Veterans that a representative payee or spouse has misused. This is exempt for the 9-month period beginning after the month it is received.
Grants, Scholarships, Fellowships, and Gifts. Any grant, scholarship, fellowship or gift (or portion of a gift) used (or retained to be used later) to pay the cost of tuition and fees at any educational (including technical or vocational education) institution as identified in 521-10. This is excluded for the 9-month period beginning after the month the funds are received (521-9).
Life Insurance. In determining the resources of an individual (or eligible spouse) an insurance policy shall be taken into account only to the extent of its cash surrender value; except that if the total face value of all life insurance policies on any person is $1,500 or less, no part of the value of any such policy shall be taken into account.
The transferred asset consists of excluded federal tax refunds or tax credits, if received between January 1, 2010 and December 31, 2011 and transferred in the month received or during the time-period the refund or credit is excluded from resources according to policy in 521-32 or 521-23. Tax credits received as part of a tax refund may include credits such as the child tax credit, the earned income tax credit, energy efficient appliances or home improvements, or first-time home buyers credit. See 417-3 and 521-32 for policy on tax refund exclusions.
The transferred asset consists of payments received by an American Indian/Alaska Native under the Individual Indian Money Account Litigation Settlement as required by Pub. L. 111-291 during the time-period they are excluded from income and resources according to policy in 521-42 or 521-28.
Other Transfers
The individual can prove the asset or income was transferred exclusively for a purpose other than to become eligible for Medicaid (575-6).
The individual intended to get full market value (575-7).
All assets or income transferred are returned to the individual (575-8).
The sanction would be an undue hardship (575-9)