(Eff.10/01/05)
Medicaid uses the value of a person’s resources as a factor in determining eligibility for Supplemental Security Income (SSI) related programs. It is generally expected that individuals or couples whose resources exceed the limit will use the excess to meet their needs before becoming eligible for Medicaid.
This chapter will describe the treatment of resources when determining eligibility for the SSI-related Medicaid programs using strict SSI resource policy (such as, OSS, Retroactive SSI, Pass-Along). Each program has an established resource limit. If countable resources exceed the limit, eligibility cannot be established. The applicable limits will be discussed in the program specific chapters of this manual.
SSI policy is used as the basis of determining financial eligibility for Medicaid for the adult categories of assistance. SSI policy is explained in the Program Operations Manual System (POMS). This manual provides references to sections in the POMS for more detailed explanations of policy and procedures.
Note:
Not everything a person owns is a resource.
Not all resources count against the limit.
The Social Security Act and other Federal laws require certain types and amounts of resources to be excluded. If a resource is not specifically excluded, it is considered countable.
In certain situations, Federal law requires other people to share financial responsibility. In those situations, their resource(s) are considered along with those of the applicant/beneficiary.
If countable resources exceed the limit, an individual or couple is not eligible.
|
402.02 Resource Limit
(Eff.10/01/05)
(POMS SI 01110.003)
Federal law establishes a limit on the value of resources an individual or couple may own and still be eligible for Medicaid. The limits for each program will be explored in the program specific chapters.
Table of Contents
402.03 Resource Definitions
(Eff.10/01/05)
Type |
Definitions
|
Examples
|
POMS
| General Definition |
All assets, including real and personal property, which an individual or couple:
Owns
Can apply toward basic needs of food, clothing, and shelter – either directly or by conversion
Is not legally restricted from use for support and maintenance
|
Home
Land
Bank Accounts
Burial Assets
Life Insurance
Automobiles
Investments
|
SI 01110.100
|
Liquid Resources
|
Cash or items that are readily converted to cash (within 20 days)
|
|
SI 01110.305
|
Non-Liquid Resources
|
Are not cash and are not readily convertible to cash
|
Building, land, and other real property rights
Vehicles
Machinery and livestock
Household goods and personal effects
Non-cash business property
|
SI 01110.310
|
Exclusion
|
A resource, or part of a resource’s value, that is not considered in the eligibility determination
|
(Refer to list in MPPM 402.15.)
|
|
Countable Resources
|
Resources remaining after all exclusions are applied.
**The current or fair market value of resources must be verified and the equity value considered.
|
|
|
Current or Fair Market Value (CMV or FMV)
|
The amount a resource can be expected to sell for on the open market or the sales price, if sold for a higher amount.
|
|
|
Equity Value
|
The current market value minus any legal debt (payoff amount)
|
House has a market value of $150,000. The mortgage payoff is $80,000. The equity value is $70,000.
|
|
Conserved Funds
|
Funds or property being held for an individual by another person
|
Daughter has $30,000 in a bank account in her name but it is actually her parents’ money. She uses it exclusively for their needs.
|
|
Table of Contents
Share with your friends: |
