All Medicaid Programs |
Obsolete Policy |
Declaration of assets
An applicant must declare at application what assets the household has and the value of those assets.
A recipient must report changes in assets and their value within ten days of a change and at review.
Certain assets must be verified by a method other than client statement.
Accept client statement of assets for medically needy Family, Child and Pregnant Woman programs when the declared assets do not exceed the applicable asset limit. However, if the agency has information that conflicts with the client statement, request verification of such assets.
Deciding how to verify assets
Electronic asset match.
The eligibility agency must complete an electronic match for assets at application, mandatory reviews, and when changes are reported that could be verified by an electronic match. Determine if the declared assets match, or are reasonably compatible with the findings on the electronic match.
Assets that must be verified.
The following assets must be verified using a method other than client statement when the client declares having such assets, or the agency has documented information that the client has such assets. Help the client get verification if the client requests help.
Trusts (512)
Burial/funeral arrangements or funds, but not including fully-paid burial spaces (Sec. 592, 594, 596)
Whole life insurance (521-16)
Non-exempt real property (real property not excluded as a home, or self-employment)
Assets of self-employment when the client claims to be self-employed, declares self-employment assets and the client's assets exceed the resource limit due to the value of those assets. (521-8)
For aged, blind and disabled Medicaid, and for long-term care programs, verify all assets at initial application, for spousal resource assessments, and for the purpose of determining if any asset transfers have occurred for long-term care applicants. At review, the agency may accept client statement of assets unless there is a reason to question the client's statement.
Verify Questionable assets.
Decide if any of the declared assets are questionable.
A questionable asset is one for which the agency has a documented reason to question the client's statement and the value of the asset could affect eligibility. A documented reason may include information found through an electronic data match, or other documentation that conflicts with a client's declaration.
The eligibility worker may contact the client to try to resolve questions when a documented reason to question declared assets exists, for example ownership of vehicles. If the eligibility worker can resolve the issue by talking to the client, it is no longer questionable.
Example: Client reports having only one vehicle; however, the electronic match shows three vehicles in the client's name. The worker calls the client to see why there is a discrepancy. Client reports that his father has the same name, and two of the vehicles belong to the father. If the explanation is credible and no other documented reason to question ownership exists, the worker can accept the client's statement.
Request verification other than client statement of the questionable assets if you cannot resolve the questions by discussing it with the client. Help the client get verification if the client requests help.
Request verification of any asset that may have an availability issue and would affect eligibility if the client's share of the value is counted. (511-5)
Decide if a client has declared any exempt assets, or if you have information about an asset that is exempt under policy.
Request verification of the asset and its value if the asset is a type of asset on the must verify list described in B.2.
Decide if counting the potentially exempt assets causes the client to exceed the asset limit.
If the client is under the asset limit even when counting a potentially exempt asset, do not request other verification of the asset.
If the client will fail the asset test when counting a potentially exempt asset, request verification of the asset. Use data match information to verify excluded SSA/SSI lump sums when possible. If the exempt assets are co-mingled with non-exempt assets, the client must state the amount that is exempt and the verification must support the statement.
If a client declares having an exempt IIM account, a Dedicated Account for an SSI Child, or an IDA, accept client statement unless there is a documented reason to question the client's statement. (Sec. 521-5, IIM accounts; 521-30, Accounts for SSI child; 521-37, IDAs.)
When a client has an account containing both exempt and non-exempt assets, assume the client uses the non-exempt funds first.
Incomplete information provided.
If the client does not provide enough information about assets and asset values to make a decision, request verification of the assets. Help the client get verification if the client requests help.
Applying the asset limit and verifying assets for medically needy Family, Child and Pregnant Woman programs
If the client does not have any assets on the "must verify" list, no questionable assets and no potentially exempt assets, determine the countable declared assets using the client's statement and reliable information the agency has available.
Compare the countable assets to the asset limit.
If assets are below the asset limit, the client has passed the asset test.
Do not request other verification of the client's assets.
If assets exceed the asset limit, the client is ineligible.
Request other verification of assets that are on the "must verify" list, or are questionable assets that could make a difference in the client's eligibility. Help the client get verification if the client requests help.
See 703-5, A.7. if an applicant provides verification within 30 days of the denial notice.
Changes and reviews
A recipient must report changes within 10 days of when the change occurs, including a change at the time of a review.
If a reported change in assets does not cause assets to be above the asset limit, accept the client's statement unless the asset is on the "must verify" list or the agency has a documented reason to question the declaration and the asset affects eligibility.
Request other verification when:
the reported change is an asset that must be verified. See B.2. above for assets that must always be verified using a method other than client statement; or
the reported change is an asset that is questionable, including potentially exempt assets, and affects eligibility.