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Medicaid beneficiaries cannot “fix” eligibility by giving away resources. A transfer of resources without receipt of fair market value will trigger calculation of a transfer penalty. “The penalty for an institutionalized individual consists of ineligibility for certain services for a period or periods of ineligibility that equal the number of months calculated by taking the […]

The answer is, yes, maybe. At USA.gov, there are tips for caregiver support including links to programs that could pay you to serve as a family caregiver. That site offers the following insight: A caregiver helps a person with special medical needs in performing daily activities. Tasks include shopping for food and cooking, cleaning the […]

Gifting is usually a last resort when creating a Medicaid Plan. The reason is gifts trigger a transfer of resources penalty. The Medicaid Transfer Penalty Worksheet can be used to calculate the penalty, but an additional worksheet is helpful when calculating the amount of income a Medicaid applicant must generate to private pay through the […]

Family

The form below was developed by the Georgia Department of Community Health and is based on Section 2342-11 of the Georgia ABD Medicaid Manual:

Pooled Trust Subaccount Established for Individual Over 65yo. An 83 year old deposited $12,320 into a pooled trust in August 2008. In November 2008, he applied for Medicaid. His application was denied. The parties stipulated the trust complied with 42 USC 1396p(d)(4)(C), but the Department took the position a transfer penalty should be applied. The […]

Direct Transfer to Disabled Child; Previously Unknown Resource. Applications for Medicaid were filed on November 24, 2008 and January 8, 2009. The first application was denied for failure to provide documentation. The second was approved on April 16, 2009 with assessment of a penalty through 2009. The transfer was directly to a disabled child rather […]

Annuity; Transfer Penalty for Failing to Name State as Beneficiary. Petitioner, a 95 year old nursing home resident, applied for Medicaid on December 15, 2008. DFCS denied eligibility and imposed a transfer of resources penalty because she had purchased an annuity without naming the State of Georgia as a beneficiary. The annuity was irrevocable and […]

Single Premium Life Insurance Contract; Penalty Reversed. On November 5, 2008, Petitioner filed an application to purchase a Single Premium Pure Endowment Life Insurance Contract. She paid $89,500 for the policy which, in five years, would pay her children $91,327.  The contract stated there was no cash surrender value and that no benefits would be […]

No Retroactive Application of Policy Changes Permitted; Payments for Renovations to Accommodate Petitioner Permitted; Payments Consistent with Prior Accepted Obligation Permitted. Petitioner was hospitalized with a stroke in 2008, after which she went to live with one of her sons until she was re-hospitalized in November 2008. Thereafter, she remained in a nursing home. Petitioner […]

Personal Services Contract rejected. Petitioner was admitted to a nursing home in October 2008,where she continued to stay. At the time, she had $36,332 in resources. Petitioner entered into a contract with Ms. Hailey to provide personal care services at the nursing home for life for $23,000. Her life expectancy was 10 more years. The […]

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