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Asset Reduction for Retroactive LTC Eligibility

This presentation from the MFWCAA Conference in October 2007 discusses effective strategies for asset reduction to establish retroactive eligibility for long-term care (LTC) benefits. Key strategies include designating burial funds, paying outstanding medical bills from the retroactive period, and understanding income and asset limits. The document outlines various case studies that showcase calculations and maneuvers to comply with eligibility criteria while managing assets and expenses effectively.

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Asset Reduction for Retroactive LTC Eligibility

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  1. Asset Reduction for Retroactive LTC Eligibility MFWCAA Conference October 2007

  2. How Can Assets Be Reduced? • Designate burial funds $1500 Limit Self, spouse, MA-eligible dependent children No burial space items • Pay oldest medical bills in retro period Not incurred before retro period Not covered by TPL

  3. Income or Asset? *Income in month received Bank balance Mar. 1 $4000 Direct deposit Mar. 1 900 Countable asset 4000 *Asset if retained Bank balance Apr. 1 $4600 Direct deposit Apr. 1 900 Countable asset 4600

  4. Case 1 • Entered LTC on April 5 • Applied for MA on April 30 • Retro request for March • Income RSDI 595 gross • Assets Checking Savings Annuity

  5. March *Assets Savings 7153 Checking 2980 Annuity 5886 Total 16,019 *Medical Bills None

  6. April • Assets 16040 • Reductions IFB 5000 Fuel bill 1050 • Medical bill NH charge 1757 (paid in May)

  7. May • Assets 8460 • Reductions 350 on miscellaneous bills • LTC Spenddown 402 • Medical bill NH charge 3750 (paid in June)

  8. June • Assets 8603 • Reduction May NH 3750 • Balance 4853 • Asset Limit 3000 • Excess 1853 • June NH charges 3710 Eligibility exists for June by paying 1853 to the nursing home.

  9. MAXIS • FIAT denial for excess assets Mar-May Cannot enter STAT data for March • Approve eligibility for June Record excess asset amount as TPL on STAT BILS Add case note and worker comment • Request new budget period 6/07-12/07 on STAT BUDG • Update review dates on STAT REVW

  10. MMIS • RSPD for June • TY =A, MTHD=I, CVD POP=M • Period begin= June 1, 2007 • Orig spenddown=2255 (LTC spenddown + excess asset) • Recipient Amt=2255 • Update for July to show ongoing LTC spenddown

  11. Case 2 • Entered LTC on October 25 • Applied on January 22 • Retro request back to October • Income RSDI + pension 1313 gross • Assets • Checking • Savings • Irrevocable burial account

  12. October • Assets Savings 8008 Checking 2292 Total 10,300 Medical bills None. Paid by Medicare. Burial Fund Exclusion already used by IBA.

  13. November • Assets 10,757 • Reductions • Grave marker 1279 • Attorney 600 • Clean out apt. 400 • Medical bills Nursing home 4616 Medicare B & D 147 Med. Supplement 233

  14. December • Assets 8687 • Reductions None • Medical Bills Nursing Home 4616 Drug copays 111 Premiums 380

  15. January • Assets 9616 • LTC Spenddown 1313 gross income -82 C & PN -380 premiums =851 • Medical bill—nursing home 4616 • Final reductions—paid 5838 to NH in March for November and part of December

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