Current through Register Vol. 41, No. 3, September 23, 2024
A. Resources to meet burial expenses.
Resources set aside to meet the burial expenses of an applicant or recipient or
that individual's spouse are excluded from countable assets. In determining
eligibility for benefits for individuals, disregarded from countable resources
is an amount not in excess of $3,500 for the individual and an amount not in
excess of $3,500 for his spouse when such resources have been set aside to meet
the burial expenses of the individual or his spouse. The amount disregarded
shall be reduced by:
1. The face value of
life insurance on the life of an individual owned by the individual or his
spouse if the cash surrender value of such policies has been excluded from
countable resources; and
2. The
amount of any other revocable or irrevocable trust, contract, or other
arrangement specifically designated for the purpose of meeting the individual's
or his spouse's burial expenses.
B. Cemetery plots. Cemetery plots are not
counted as resources regardless of the number owned.
C. Life rights. Life rights to real property
are not counted as a resource. The purchase of a life right in another
individual's home is subject to transfer of asset rules. See
12VAC30-40-300.
D. Reasonable effort to sell.
1. For purposes of this section, "current
market value" is defined as the current tax assessed value. If the property is
listed by a realtor, then the realtor may list it at an amount higher than the
tax assessed value. In no event, however, shall the realtor's list price exceed
150% of the assessed value.
2. A
reasonable effort to sell is considered to have been made:
a. As of the date the property becomes
subject to a realtor's listing agreement if:
(1) It is listed at a price at current market
value; and
(2) The listing realtor
verifies that it is unlikely to sell within 90 days of listing given the
particular circumstances involved (e.g., owner's fractional interest; zoning
restrictions; poor topography; absence of road frontage or access; absence of
improvements; clouds on title, right of way or easement; local market
conditions);
b. When at
least two realtors refuse to list the property. The reason for refusal must be
that the property is unsaleable at current market value. Other reasons for
refusal are not sufficient; or
c.
When the applicant has personally advertised his property at or below current
market value for 90 days by use of a "Sale By Owner" sign located on the
property and by other reasonable efforts, such as newspaper advertisements, or
reasonable inquiries with all adjoining landowners or other potential
interested purchasers.
3. Notwithstanding the fact that the
recipient made a reasonable effort to sell the property and failed to sell it,
and although the recipient has become eligible, the recipient must make a
continuing reasonable effort to sell by:
a.
Repeatedly renewing any initial listing agreement until the property is sold.
If the list price was initially higher than the tax-assessed value, the listed
sales price must be reduced after 12 months to no more than 100% of the
tax-assessed value.
b. In the case
where at least two realtors have refused to list the property, the recipient
must personally try to sell the property by efforts described in subdivision 2
c of this subsection for 12 months.
c. In the case of a recipient who has
personally advertised his property for a year without success (the newspaper
advertisements and "for sale" sign do not have to be continuous; these efforts
must be done for at least 90 days within a 12-month period), the recipient must
then:
(1) Subject his property to a realtor's
listing agreement at price or below current market value; or
(2) Meet the requirements of subdivision 2 b
of this subsection, which are that the recipient must try to list the property
and at least two realtors refuse to list it because it is unsaleable at current
market value; other reasons for refusal to list are not sufficient.
4. If the recipient has
made a continuing effort to sell the property for 12 months, then the recipient
may sell the property between 75% and 100% of its tax assessed value and such
sale shall not result in disqualification under the transfer of property rules.
If the recipient requests to sell his property at less than 75% of assessed
value, he must submit documentation from the listing realtor, or knowledgeable
source if the property is not listed with a realtor, that the requested sale
price is the best price the recipient can expect to receive for the property at
this time. Sale at such a documented price shall not result in disqualification
under the transfer of property rules. The proceeds of the sale will be counted
as a resource in determining continuing eligibility.
5. Once the applicant has demonstrated that
his property is unsaleable by following the procedures in subdivision 2 of this
subsection, the property is disregarded in determining eligibility starting the
first day of the month in which the most recent application was filed, or up to
three months prior to this month of application if retroactive coverage is
requested and the applicant met all other eligibility requirements in the
period. A recipient must continue his reasonable efforts to sell the property
as required in subdivision 3 of this subsection.
E. Automobiles. Ownership of one motor
vehicle does not affect eligibility. If more than one vehicle is owned, the
individual's equity in the least valuable vehicle or vehicles must be counted.
The value of the vehicles is the wholesale value listed in the National
Automobile Dealers Official Used Car Guide (NADA) Book, Eastern Edition (update
monthly). In the event the vehicle is not listed, the value assessed by the
locality for tax purposes may be used. The value of the additional motor
vehicles is to be counted in relation to the amount of assets that could be
liquidated that may be retained.
F.
Life, retirement, and other related types of insurance policies. Life,
retirement, and other related types of insurance policies with face values
totaling $1,500 or less on any one person 21 years old and older are not
considered resources. When the face values of such policies of any one person
exceed $1,500, the cash surrender value of the policies is counted as a
resource.
G. Long-term care
partnership insurance policy (partnership policy). Resources equal to the
amount of benefits paid on the insured's behalf by the long-term care insurer
through a Virginia issued long-term care partnership insurance policy shall be
disregarded. A long-term care partnership insurance policy shall meet the
following requirements:
1. The policy is a
qualified long-term care partnership insurance policy as defined in §
7702B(b) of the Internal Revenue Code of 1986.
2. The policy meets the requirements of the
National Association of Insurance Commissioners (NAIC) Long-Term Care Insurance
Model Regulation and Long-Term Care Insurance Model Act as those requirements
are set forth in § 1917(b)(5)(A) of the Social Security Act (
42 USC
§
1396p) .
3. The policy was issued no earlier than May
1, 2007.
4. The insured individual
was a resident of a partnership state when coverage first became effective
under the policy. If the policy is later exchanged for a different long-term
care policy, the individual was a resident of a partnership state when coverage
under the earliest policy became effective.
5. The policy meets the inflation protection
requirements set forth in § 1917(b)(1)(C)(iii)(IV) of the Social Security
Act.
6. The Insurance Commissioner
requires the issuer of the partnership policy to make regular reports to the
federal Secretary of Health and Human Services that include notification of the
date benefits provided under the policy were paid and the amount paid, the date
the policy terminates, and such other information as the secretary determines
may be appropriate to the administration of such partnerships. Such information
shall also be made available to the Department of Medical Assistance Services
upon request.
7. The state does
not impose any requirement affecting the terms or benefits of a partnership
policy that the state does not also impose on nonpartnership
policies.
8. The policy meets all
the requirements of the Bureau of Insurance of the State Corporation Commission
described in 14VAC5-200.
I. Resource exemption for Aid to Dependent
Children related medically needy (§ 1902(a)(10)(C) of the Act). For
ADC-related medically needy cases, any individual or family applying for or
receiving assistance may have or establish one interest-bearing savings or
investment account per assistance unit not to exceed $5,000 if the applicant,
applicants, recipient or recipients designate that the account is reserved for
purposes related to self-sufficiency. Any funds deposited in the account shall
be exempt when determining eligibility for medical assistance for so long as
the funds and interest remain on deposit in the account. Any amounts withdrawn
and used for purposes related to self-sufficiency shall be exempt. For purposes
of this section, purposes related to self-sufficiency shall include, but are
not limited to, (i) paying for tuition, books, and incidental expenses at any
elementary, secondary, or vocational school, or any college or university; (ii)
for making down payment on a primary residence; or (iii) for establishment of a
commercial operation that is owned by a member of the medical assistance
unit.
J. Disregard of resources.
The Commonwealth of Virginia will disregard all resources for categorically
needy children, pregnant women, and caretaker relatives covered under
§§ 1902(a)(10)(A)(i)(I), 1902(a)(10)(A)(i)(III),
1902(a)(10)(A)(i)(IV), 1902(a)(10)(A)(i)(VI), 1902(a)(10)(A)(i)(VII),
1902(a)(10)(A)(ii)(IV), 1902(a)(10)(A)(ii)(VIII), 1931, and 1905(n) of the
Social Security Act.
K. Household
goods and personal effects. The Commonwealth of Virginia will disregard the
value of household goods and personal effects. Household goods are items of
personal property customarily found in the home and used in connection with the
maintenance, use and occupancy of the premises as a home. Examples of household
goods are furniture, appliances, televisions, carpets, cooking and eating
utensils and dishes. Personal effects are items of personal property that are
worn or carried by an individual or that have an intimate relation to the
individual. Examples of personal property include clothing, jewelry, personal
care items, prosthetic devices and educational or recreational items such as
books, musical instruments, or hobby materials.
L. Determining eligibility based on
resources. When determining Medicaid eligibility, an individual shall be
eligible in a month if his countable resources were at or below the resource
standard on any day of such month.
M. Working individuals with disabilities
eligible for assistance under § 1902(a)(10)(A)(ii)(XV) of the Act who wish
to increase their personal resources while maintaining eligibility for Medicaid
shall establish Work Incentive (WIN) accounts. The Commonwealth will disregard
up to the current annual SSI (Social Security Act, § 1619(b)) threshold
amount (as established for Virginia by the Social Security Administration) held
in WIN accounts for workers with disabilities eligible for assistance under
§ 1902(a)(10)(A)(ii)(XV) of the Act. To be eligible for this resource
disregard, WIN accounts are subject to the following provisions:
1. Deposits to this account shall derive
solely from the individual's income earned after electing to enroll in the
Medicaid Buy-In (MBI) program.
2.
The balance of this account shall not exceed the current annual SSI (Social
Security Act § 1619(b)) threshold amount (as established for Virginia by
the Social Security Administration).
3. This account will be held separate from
nonexempt resources in accounts for which prior approval has been obtained from
the department, and for which the owner authorizes regular monitoring and
reporting including deposits, withdrawals, and other information deemed
necessary by the department for the proper administration of this
provision.
4. A spouse's resources
will not be deemed to the applicant when determining whether or not the
individual meets the financial eligibility requirements for eligibility under
this section.
5. Resources
accumulated in the Work Incentive account shall be disregarded in determining
eligibility for aged, blind, and disabled Medicaid-covered groups for one year
after the individual leaves the Medicaid Buy-In program.
6. In addition, excluded from the resource
and asset limit include amounts deposited in the following types of
IRS-approved accounts established as WIN accounts: retirement accounts, medical
savings accounts, medical reimbursement accounts, education accounts and
independence accounts. Assets retained in these WIN accounts shall be
disregarded for all future Medicaid eligibility determinations for aged, blind,
or disabled Medicaid-covered groups.
N. For all aged, blind, or disabled
individuals, both categorically needy and medically needy, the Commonwealth
shall disregard as resources amounts received as payment for involuntary
sterilization under the Virginia Eugenical Sterilization Act, beyond the
allowable nine-month exclusion by the SSI program's resource
methodologies.
Statutory Authority: §
32.1-325 of the Code of Virginia; 42 USC §
1396 et
seq.
