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LIMITATION ON HOME EQUITY FOR LONG TERM CARE ASSISTANCE 2.12.a

Individuals who have an equity interest in their home that exceeds $750,000 are not eligible for LT unless one of the following conditions apply:

 the individual has a spouse who lives in the home;  the individual has a child under 21 who lives in the home;  the individual has an adult child who is disabled living in the home; or  the limitation has been waived by the Medical Assistance Administration in the Department of Health, due to undue hardship.

TRANSFER OF ASSETS BEFORE OR AFTER ELIGIBILITY DETERMINATION 2.13

When an otherwise eligible institutionalized individual disposes of any countable assets for less than fair market value during or after a “look-back period”, impose a period of restricted Community Medicaid coverage. The look-back period is a period of time immediately before:

 the date the individual becomes an institutionalized individual if s/he is eligible for Community Medicaid on that date, or  the date the individual applies for assistance while an institutionalized individual if s/he is not eligible for Community Medicaid on the date of institutionalization and the uncompensated value of the transferred asset exceeds the monthly cost of care. The uncompensated value is the difference between the fair market value and the amount that was actually paid for the item.

The look-back period depends upon the date of asset transfer:

 For transfers made before February 8, 2006, the look-back period is 36 months.  For transfers made on or after February 8, 2006, the look-back period is 60 months.  Effective February 8, 2011, the look-back period will always be 60 months.

Determine the period of restricted coverage in months by dividing the total uncompensated value by the average monthly cost of nursing home care in DC. If the calculation results in a partial month at the end of the period, the individual is only eligible for LTC for the portion of the month after the partial period ends. The total uncompensated value is the result of subtracting the payment actually received, if any, from the fair market value of the asset.

Effective September 1, 2010, the average monthly cost of nursing home care in DC is $10,333.00. For periods prior to September 1, 2010, the average cost of care was $7,149.00.

The start date of the period of restrictive coverage depends upon the date of the asset transfer:

 For transfers made before February 8, 2006, the period of restrictive coverage begins on the first day of the month in which the transfer was made, regardless of the date of the month the transfer actually occurs;  For transfers that occurred on or after February 8, 2006, the period of restricted coverage begins on the later of the following; o The month of transfer, regardless of the date in a month the transfer is made, or