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COMAR 10.09.24.04

337 State of Maryland Medical Assistance Manual Revised July 2012

the company cannot be found any information available on the cash valued of the life insurance may be used. If no information can be obtained on the cash value, the life insurance is excluded as a resource. If the A/R makes a good faith effort to obtain information on the cash value, the eligibility determination is not delayed or denied due to the inability to determine the current cash value of life insurance.

(e) Real Property

Excludability of Home Property There are three situations in which a home property of an institutionalized person may be excluded when determine the persons countable resource: The institutionalized person or his/ her representative expresses the intent to return his/her home and resume living there. The intent is obtained in writing on the DHMH form 4255- Home exclusion statement of intent The spouse of the institutionalized person is resuming in the home. The home is excluded as a countable resource when determining MA eligibility, regardless of the institutionalized person’s intent to return. However, the house must be evaluated under the lien provisions if applicant is determined eligible for MA. A dependent relative of an institutionalized person is residing in the home.

400.18 Verification for deductions from available income for the cost of care

(a) Health Insurance

In order for the CM to deduct only the institutionalized person’s health insurance premiums from the available income towards the cost of care, the CM needs either a recent premium bill or a canceled check for a premium payment, as well s a copy of the front and back of the health insurance card. If the CM has reason to believe that the premium being paid is for someone other than the institutionalized person, the CM contact the insurance company to verify the policy’s insured member(s).

(b) Residential Maintenance allowance

It is not required shelter expenses or obtains a copy of the mortgage, lease or rental agreement. However, the DHMH 4245 Physician’s Report and the DHMH 4255 Home exclusions-Statement of Internet are required in order to deduct a residential maintenance allowance, if the institutionalized person intends to return to the home property.

(c) Spousal Maintenance Allowance

If the community spouse does not report shelter expenses on the DES 2003 form, the basic maintenance and shelter allowance is deducted for the spouse. The community spouse’s income must still be reported.