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If all contributions plus the resources of the deceased exceed $400 but are less than $1,200, the $800 maximum payment from state funds to the cemetery will be reduced dollar for dollar by the amount in excess of $400. The cemetery representative's payment will be up to $800 or the amount of his unpaid expenses, whichever is less.

EXAMPLE #1:

Contributions = $500 Cemetery Expenses = $1200

$500 - $400 (exclusion) = $100 $800 (maximum payment) - $100 = $700 payment to the cemetery

4810.10.05.15

CONTRIBUTIONS/RESOURCES OF $400 OR LESS (C)

If all contributions plus the resources of the deceased total $400 or less, the cemetery representative's payment will be $800 or the amount of his unpaid expenses, whichever is less.

EXAMPLE #1:

Resources = $300 Cemetery Expenses = $1500

$300 - $400 (exclusion) = $0

$800 (maximum payment) to the cemetery

4815.00.00 SUBMISSION OF BURIAL CLAIMS TO THE DFR (C)

Except as provided in Subsection 4815.05.00, the funeral director and the cemetery representative are to file separately for payment of the deceased recipient's burial expenses. (f6) The form used for this purpose is State Form 35937 (R3/3-04)/ FM0033 Application and Claim for Funds to Defray Burial Costs of Medicaid Aged, Blind, and Disabled Recipients. When a determination has been made by the DFR that the estate of the deceased recipient could make full or partial payment for burial expenses, the claimant must attach documentation to the claim to substantiate that the estate was insufficient to pay the burial expenses. 4815.05.00 SUBMISSION OF CEMETERY CLAIM BY FUNERAL DIRECTOR (C)

A funeral director may file and receive payment for cemetery expenses if he attaches proof to the claim that: