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VA Medicaid Resource Exclusions

Your financial eligibility for Medicaid coverage may be limited by the amount of resources your Assistance Unit has. The limits depend on what Medicaid Covered Group you are in.

Resources are cash and any other personal or real property that an individual (or spouse):

·             owns;

·             has the right, authority, or power to convert to cash (if not already cash); and

·             is not legally restricted from using for his/her support and maintenance

Any property (an asset) that does not meet the criteria above is not a resource even though it may be an asset (e.g., an individual who has an ownership interest in property but is not legally able to transfer that interest to anyone else does not have a resource).

Some resources are not counted when determining whether or not a resource limit is exceeded:

Resource Exclusions for ABD Covered Groups:

·             Your Home: Your dwelling and the lot it occupies are excluded. Also excluded is adjoining property that is not essential to the operation of your home up to an equity value of $5,000 (in 2011). (Note: For the Medicare-Related covered groups and the 80% of FPL covered group, the $5,000 limit does not apply.)

·             One Automobile or other Vehicle: Ownership of one vehicle is not counted as resource. (This includes any vehicle used for transportation. It can include, in addition to cars and trucks, boats, snowmobiles, animal-drawn vehicles, and even animals. Additional vehicles are valued as listed in the National Automobile Dealers Association Guide, available online at http://www.nadaguides.com/. The vehicle with the highest equity value is excluded.

NOTE: For special rules regarding automobiles for Qualified Disabled Working Individuals (QDWI), see Appendix 1 of Chapter S11 of the Department of Social Services (DSS) Medicaid Manual.

·             Burial Insurance, Life Insurance for burial purposes, Funds set aside for burial purposes, and Burial Plots: Insurance that can only be used for burial purposes or up to $3,500 (in 2011) of life insurance is excluded. Up to $3,500 (in 2011) of savings can be excluded if held in a separate account. Also excluded (in addition to the above) can be the value of burial plots.

The Cash Surrender Value (CSV) (higher than $3,500 for burial purposes) of life insurance with a face value of more than $1,500 is counted as a resource.

·             Household Goods and Personal Effects: Household goods and personal effects are excluded resources for Medicaid eligibility determinations.

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. They include, but are not limited to: furniture, appliances, televisions sets, carpets, cooking and eating utensils, dishes, etc.

Personal Effects are items of personal property that are worn or carried by an individual or that have an intimate relation to him or her. They include, but are not limited to: clothing, jewelry, personal care items, prosthetic devices, and educational or recreational items such as books, musical instruments, or hobby materials.

·             Property Essential to Self-Support: Such property includes property used in a trade or business, property used for or required for work, up to an equity value of $6,000 (in 2011) in non-business property used to produce goods or services essential to daily activities. (For example, it covers land used to produce vegetables or livestock solely for consumption by the individual's household.) It also includes up to $6,000 in non-business income-producing property if it earns at least 6% return.

·             Resources included in a Plan for Achieving Self-Support (PASS): You can exclude resources that you spend or save for expenses that SSA agrees will help you move toward a goal that will make you financially more self-supporting. You must include such resources in an SSA-approved PASS.

·             Retroactive SSI or SSDI benefits: The unspent portion of retroactive SSI or SSDI benefits received on or after 11/01/2005 is excluded for the nine calendar months following the month in which the benefits are received. Prior to this date, the exclusion period was six months.

Retroactive SSI benefits include benefits issued in any month after the calendar month for which they are paid.

Retroactive SSDI benefits include benefits issued in any month that is more than a month after the calendar month for which they are paid.

·             Unspent Netherlands Persecution Payments, German Reparation Payments, and Austrian Social Insurance Payments: Note that the interest income on such resources count as income and, if unspent, as resources.

·             Disaster Assistance: Most disaster assistance is permanently excluded. Interest on such unspent assistance is also excluded from both income and resources.

·             Cash or In-Kind Items Replacing Excluded Resources: Cash and in-kind receipts from any source for the replacement or repair of lost, damaged, or stolen excluded resources are themselves not treated as resources for 9 months form the date of their receipt (or longer if there is good cause why repair or replacement was not possible during the first 9 months).

·             Benefits Excluded by other Federal Statutes: For a list of such benefits, see ABD Unearned Income Exclusions.

·             Victim's Compensation Payments: Compensation for expenses incurred or losses suffered as the result of crime is excluded from resources for 9 months. Interest earned on unspent payments is not excluded.

·             Earned Income Tax Credits (EITCs): Any unspent Earned Income Tax Credit (EITC) refunds or payments are excluded only for the month following the month the refund or payment is received. Interest on unspent EITC payments is not excluded.

See Also:

VA Medicaid Resources Defined

Back to:

VA Medicaid Eligibility

VA Medicaid Covered Groups

VA Medicaid Overview

VA Benefit Information System Welcome and Introduction

Source:

Information for this topic was drawn from Chapter S1130 of the Department of Social Services (DSS) Medicaid Manual.

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