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Medicaid Program - Resource Limits - Oklahoma

There are two sets of resource limits for Medicaid programs in Oklahoma. One applies to aged, blind, or disabled people under the regular Medicaid program, and the other applies to people with limited incomes who are qualified or specified Medicare beneficiaries.

General

The term "resources" is a general term representing any form of real and/or personal property that has an available money value. All available resources, except those required to be disregarded by law or by policies of the Oklahoma Health Care Authority (OHCA) or DHS are considered in determining need. In determining eligibility for Medicaid, only those resources available for current use are considered as countable resources.

Resources are evaluated on a monthly basis. An applicant is determined ineligible for any month that resources exceed the resource standard at any time during that month. When a recipient has resources that exceed the resource standard, case closure action is taken for the next possible effective date.

If a husband and wife are living together, a capital resource and/or income available to one spouse constitutes a resource and/or income to the other. If the husband and wife are separated, but not divorced or legally separated, they constitute a possible resource to each other.

Home property is excluded from resources regardless of value. For purposes of the home property resource exclusion, a home is defined as any shelter in which the individual has an ownership interest and which is used by the individual as his/her principal place of residence. The home may be either real or personal property, fixed or mobile. Home property includes all property which is adjacent to the home.

Certain items are excluded when calculating resources, such as the home and furnishings, certain burial funds and contracts, real and/or personal property that produces income under specified conditions, personal property necessary to perform daily living activities (if the equity value does not exceed $6,000), and other items.

One vehicle (automobile, pickup or truck) per family is excluded from counting as a resource if its current market value (CMV) does not exceed $4,500. The CMV in excess of $4,500 is counted against the resource limit. The entire CMV of one vehicle is excluded if the vehicle is used at least four times per year to either obtain medical treatment or prescription drugs, is used for employment purposes, or is especially equipped for operation by or transportation of a handicapped person. The equity value (CMV less encumbrances) of all other vehicles is included in the calculation of resources.

Resource Limits for Aged, Blind, and Disabled

Financial resources must be equal to or below specified values in order to be eligible. There is one limit for an individual only and a higher limit for an individual and spouse. These numbers are the same as the SSI program resource limits, and have been in effect for many years. The limits are referenced in Oklahoma DHS Appendix C-1 at Schedule VIII.D, where they are called "Maximum Reserve".

Resource Limits for Qualified or Specified Medicaid Beneficiaries

Financial resources must be equal to or below specified values in order to be eligible. There is one limit for an individual only and a higher limit for an individual and spouse. These numbers represent twice the SSI program resource limits.

Resource limits are referenced in Oklahoma DHS Appendix C-1, where they are called either "Resources" or "Resource Standard". The resource limits are identical for the various programs, but each is shown in a separate table due to the different income limits. See Schedule V for Qualified Disabled and Working Individuals (QDWI), Schedule VI for Qualified Medicare Beneficiary Plus (QMBP), Schedule VII for Specified Low-Income Medicare Beneficiaries (SLMB), Schedule VII.A for Qualifying Individuals - Group 1 (QI-1s), and Schedule VII.B for Qualifying Individuals - Group 2 (QI-2s).

For further information, see:

OAC 317:35-5-41 at OK Department of Human Services Policy.

Also see:

Medicaid Program - Countable Income - Oklahoma

Medicaid Program - Income Disregards - Oklahoma

Medicaid Program - Eligibility - Oklahoma

Medicaid Program - Eligibility for People Who Are Blind and Disabled - Oklahoma

Medicaid Program - Eligibility for Elderly Individuals - Oklahoma

Medicaid Program - Eligibility for Pregnant Women and Children - Oklahoma

Medicaid Program - Overview - Oklahoma

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