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Asset Reduction for Retroactive LTC Eligibility

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

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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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