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not considered conversions. If payments are made to the account owner, the following are not considered uncompensated asset transfers and do not require beneficiary assignment to the State of Montana Medicaid Program: 1. an individual retirement annuity [subsection (b) of section 408 of the IRS Code of 1986], a qualified employer plan annuity [subsection (q) of section 408 of the IRS Code of 1986]; 2. purchase of an annuity with an IRA, employer or employee association account; 3. a qualified salary reduction arrangement [section 408(a), (c), or (p) of the IRS Code of 1986]; OR 4. a simplified employee pension [within the meaning of section 408(k) of the IRS code if 1986]. If one of these situations is alleged, request assistance from the policy specialist in determining whether the criteria are met.

ANNUITIES PURCHASED AFTER ELIGIBILITY DETERMINATION: If the Medicaid client or their community spouse purchase an annuity after eligibility has been determined, they must report that purchase following normal change reporting requirements and must amend the annuity to meet the above requirements to remain eligible. If the community spouse refuses to make the Montana Medicaid Program the primary remainder beneficiary, the purchase is considered an uncompensated asset transfer and results in a penalty being imposed against the nursing home spouse. The exemptions listed below do not apply to this requirement. Even if the annuity meets #1- 7 above, other events may result in an annuity being considered an uncompensated asset transfer. These include, but are not limited to, taking any action that causes the annuity to be inaccessible (versus irrevocable/non-assignable).

JOINTLY OWNED: Any action taken to reduce the Medicaid client’s or spouse’s ownership, or control of an asset held in sole ownership, or with another individual under joint tenancy, tenancy in common, joint ownership or another similar arrangement, is considered a transfer. EXAMPLES: 1. Jim adds his daughter’s name to his checking account. If she uses any of the funds for anything other than providing for Jim, an asset transfer has occurred. 2. Tom decides to add his daughter’s name to his home’s title. She now must agree to sell/dispose of the home, which wasn’t previously necessary. Because Tom’s right to sell/dispose of his home has been limited, adding his daughter’s name to the title is considered an asset transfer. 3. The community spouse (CS) removes her husband’s (nursing home spouse) name from a joint CD and adds her daughter’s name; this is done during the 90- day period when assets allocated to the CS must be transferred from the nursing home spouse to the CS. Substituting her daughter’s name for the nursing home spouse’s name on this document results in an uncompensated asset transfer.