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MEDICAL SERVICES POLICY MANUAL, SECTION E

E 600 Achieving a Better Life Experience (ABLE) Program

longer causes the recipient to exceed the resource limit and the individual is otherwise eligible.

EXAMPLE: Excess Resources-Recipient is Suspended but Retains Health Care Eligibility: Paul is the designated beneficiary of an ABLE account with a balance of one hundred one thousand dollars ($101,000) on the first of the month. Paul’s only other countable resource is a checking account with a balance of one thousand five hundred dollars ($1,500). Paul’s countable resources are two thousand five hundred dollars ($2,500) and therefore exceed the SSI resource limit. However, since Paul’s ABLE account balance is causing him to exceed the resource limit (for example, his countable resources other than the ABLE account are less than two thousand dollars ($2,000)), Social Security will suspend Paul’s SSI eligibility and stop his cash benefits, but Paul will retain eligibility for health care.

NOTE: The special suspension rule does not apply when the balance of an SSI recipient’s ABLE account exceeds one hundred thousand dollars ($100,000) by an amount that causes the recipient to exceed the SSI resource limit but the resources other than the ABLE account alone would make the individual ineligible for SSI due to excess resources.

EXAMPLE: Combination of Resources-Recipient Loses SSI Eligibility: Christine is the designated beneficiary of an ABLE account with a balance of one hundred one thousand dollars ($101,000) on the first of the month. Christine also has a checking account with a balance of three thousand dollars ($3,000). Christine’s countable resources are four thousand dollars ($4,000) and exceed the SSI resource limit. However, because her ABLE account balance is not the cause of her excess resources, the special rule does not apply, and Christine is no longer SSI eligible due to excess resources. The Social Security Administration will suspend her SSI benefits and her health care benefits will end as well.

EXAMPLE: Sharon takes a distribution of five hundred dollars ($500) from her ABLE account in May to pay for her rent for the month of June. She deposits the five hundred dollars ($500) into her checking account in May and then withdraws five hundred dollars ($500) in cash on June 3 and pays her landlord. This distribution is a housing related QDE and a part of Sharon’s checking account balance on June 1, which makes it a countable resource for the month of June.