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NOTE: Uncompensated asset transfers made after application are also subject to penalty. The date of the first Medicaid application while the individual is either in a long- term care facility or qualifies for waiver services establishes the look-back period; application disposition (approved or denied for any reason) does not matter. Only one look-back period is established for each client, regardless of the number of times they are institutionalized or submit applications. Once the look-back period is established, all asset transfers after that date must be evaluated and, if necessary, a penalty calculated. When retroactive coverage is requested, the look-back period begins the first day of the first retro month requested, provided LTC eligibility exists (e.g., application received December 15, 2015, and retro coverage is requested and LTC eligibility begins October 1, 2015, look-back period begins October 1, 2010). ASSETS: Assets include all resources and retained income the client and/or their spouse: 1. Owns; 2. Is entitled to receive; 3. Is entitled to receive the benefit of (such as being a beneficiary of a trust); or 4. Would be entitled to receive except for some action or inaction which results in failure to obtain the asset.

NOTE: Assets that comprise the client’s $2000 allowable resources are NOT subject to asset transfer rules. However, excluded assets, specifically the client’s home, are subject to these rules.

PURCHASE OF AN ANNUITY: If either the client or their community spouse purchases an annuity, an uncompensated asset transfer is evaluated. Annuities purchased or converted on or after February 8, 2006, by a Medicaid client or community spouse are considered uncompensated asset transfers (subject to rebuttal) unless the: 1. The annuity payments are made to the Medicaid applicant/recipient or community spouse; 2. Periodic scheduled payments are required at least annually; 3. Payment contract calls for equal payments; no deferred or balloon payments; 4. Payment schedule is actuarially sound (equal payments are based on expectation of a full payout within the annuitant’s life); 5. Annuity is irrevocable; 6. Annuity is non-assignable; AND 7. Annuity names the Montana Medicaid Program as the irrevocable first position residual beneficiary. Refer to CMA 402-1 Countable and Excluded Resources.

Certain changes to an annuity are considered annuity conversions. These include annuitizing a previously un-annuitized annuity or change an annuity from one type to another. Automatic events such as the start of pre-arranged payments or other actions taken by the annuity company that are not voluntary on the part of the annuity owner are