Department of Human Services: Chapter 3: 3.1 thru 3.6.1
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IMA POLICY MANUAL
PART VI: FINANCIAL ELIGIBILITY REQUIREMENTS
 
CHAPTER 3:  Determining Asset Eligibility
 
Introduction 3.1
 
At application, use the assets available on the date of application, unless the applicant's assets change before application disposition.  Assets are available if an individual has both legal authority and actual ability to use them for self support. When an individual owns an asset in whole or in part, presume the asset is wholly available unless the individual proves it is not (see Chapter 1:  Determining Countable Assets in this Part).  If excess assets exist at application, deny the application.
 
In on-going cases, use the assets the group expects to have in the payment month.  The case should be closed for the month of ineligibility.
 
To be eligible for MA under some eligibility categories, groups must have countable assets below a specified level.  Some categories do not, however, impose an asset test.  Specifically, children and pregnant women who meet the non-financial and income-eligibility criteria under 'Poverty Level Families and Children' within the AR program type and children, parents, and caretaker relatives eligible under the categories within the AX program type do not have to meet an asset test (see Section 2.2.2:  ACEDS MA Program Types in Part I).  Also, FS and MA groups which are categorically eligible do not have to meet an asset test (see Chapter 12:  Categorical Eligibility in Part IV).
 
This chapter relates only to the treatment of assets for programs or eligibility groups within programs that impose an asset test on applicants and recipients.  Thus, in this chapter when the term 'ALL' is used to indicate the programs to which a particular policy apply, the term only includes those programs and eligibility categories within programs that apply an asset test.  Similarly, in this chapter, the term 'MA' only includes those eligibility categories within Medicaid and D.C. Medical Charities that impose an asset test.  For clarity, when MA is broken into subgroups in this chapter, a notation will be made to indicate that the asset-related discussion does not apply to certain categories.
 
 
Legal Authority 3.2
 
AREA/TOPIC  DISTRICT FEDERAL
Determining Asset Eligibility
D.C. Code 3-205.10-11; 3-217.5
 
GC:  See TANF and D.C. Code 3-205.5a.
MA:  42 USC 1396a(l), 1396a(r)(2); 1396u-1; 42 CFR 435.601, 435.840-.845
 
TANF:  45 CFR 265.10
 
FS:  7 USC 2014(a),(g),(j);7 CFR 273.8
 
 
Asset Limits 3.3
 
ALL 
ALL A group is ineligible when the total value of its countable assets exceeds the asset limit for the pertinent program.
 
Exhibit VI-1:  Asset Limits shows the asset limits for each program by ACEDS program type and group.
 
 
Determining Asset Eligibility/Asset Budgeting 3.4
 
MA
Groups which are categorically eligible do not have to meet the asset limits listed in Exhibit VI-1:  Asset Limits.  A group is categorically eligible if all eligible MA group members receive or are authorized to receive TANF, GC,  and/or SSI benefits (see Section 12.3:  Who is Categorically Eligible in Part IV).
 
For groups subject to an asset test, asset eligibility exists when the group's countable assets are below the applicable MA asset limit for at least one day during the month being tested.
 
TANF Determine asset eligibility using the group's assets for the payment month.  The group is ineligible if its assets exceed the applicable limit during any day of the month (see Exhibit VI-1:  Asset Limits).
Example
A group receiving TANF exceeded the asset limit on July 8 and reported it on July 15.  The group verifies it no longer had excess assets on July 19.  Recoup July TANF benefits.  Continue August benefits because the group's assets are within the asset limit for that month.  If the group had also been receiving MA, there would have been no break in MA coverage for the group.
GC
See TANF.
FS  
Groups which are categorically eligible do not have to meet the asset limits listed in Exhibit VI-1:  Asset Limits.  A group is categorically eligible (see Section 12.3:  Who is Categorically Eligible in Part IV) if:
 
  • All eligible FS group members receive or are authorized to receive TANF and/or SSI benefits. 
  • No group member is disqualified for FS because of an IPV.
For all other applicant groups, use the asset group's countable assets on the interview date to determine the initial eligibility of the group.
 
For on-going cases, if the asset limit is exceeded at any point during the month, the group is ineligible for that month (see Sections 6.3-6.4.4 in Part VIII for rules for when an overpayment should be charged and benefits recouped).  The group may reapply and be determined eligible if the assets are again below the limit.
 
 
Determining Retroactive Eligibility 3.5
 
MA
AR:  When a person applies for Medicaid, s/he can also apply for three months of retroactive eligibility.  In order to determine retroactive eligibility, consider the applicant's resources during each month of  the three-month period and compare it to the appropriate standard in Exhibit VI-1:  Asset Limits.
 
AX:  N/A.
 
SR:  See AR.
 
QM:  QMBs, Q1-1s and Q1-2s are not eligible for retroactive eligibility.  For SLIMBs and QDWIs, see
AR.
 
MC:  N/A
 
TANF
N/A
GC
N/A
FS  
N/A
 
Verification 3.6
 
Requirements 3.6.1
 
MA
AR – TANF Standard:  If the applicant is categorically eligible, no verification is required.  Otherwise, verify assets.
 
AR – Foster Care/Department Ward/Adoption Assistance Recipient:  All individuals in this group are categorically eligible for MA.  Thus, assets do not need to be verified.
 
AR – Medically Needy Standard:  Do not require verification when assets exceed the limit based on the client's statement of value.
 
Otherwise, require verification of the value of countable assets at application, redetermination, or when a change in assets is reported.  Require verification of the ownership of all assets at application and when a change is reported.
 
AR – Poverty Level Families and Children:  N/A
 
AX:  N/A
 
SR – SSI Recipients:  If the applicant receives SSI, no verification is required.
 
SR – Aged/Disabled:  See AR – Medically Needy Standard.
 
QM:  See AR – Medically Needy Standard.
 
MC:  See AR – Medically Needy Standard.
 
TANF See AR – Medically Needy Standard.
 
GC 
See AR – Medically Needy Standard.
 
FS
Require verification only if the information provided would affect group eligibility and is questionable (i.e., unclear, inconsistent, or incomplete).