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policy to a third party; and

2) The purchase price of the annuity is expected to be paid back in full during the actual or expected lifetime of the annuitant, (Follow procedures in IX.A.1. a. (2) above to determine if the beneficiary is expected to live long enough to receive full payments), and

3) The annuity provides for payments in equal amounts during the term of the annuity, with no deferral and no balloon payments.

B. Promissory Notes, Loans, Mortgages, or Other Property Agreements

A promissory note, loan, mortgage, or other property agreement must have a current market value at least equal to the value of the transferred asset. Consider a promissory note, loan, mortgage, or other property agreement that does not meet all the criteria below a transfer of assets.

1. Determine the sanction period using the remaining balance owed on the note, loan, mortgage, or other property agreement at the date of application or request for institutional services.

2. The purchase/establishment or receipt of a promissory note, loan, mortgage, or other property agreement is considered an uncompensated transfer unless the repayment agreement meets the criteria below.

a. The total value of the note, loan, mortgage, or other property agreement is expected to be paid back in full during the actual or expected lifetime of the lender/beneficiary, and

b. Repayment must be made in equal amounts during the term of the note, loan, mortgage, or other property agreement with no deferral payments and no balloon payments, and

c. The agreement prohibits the cancellation of the balance upon the death of the lender. Use the Life Expectancy Table to determine the lender/beneficiary’s life expectancy at the time of purchase to determine if note, loan, mortgage, or other property agreement is expected to be paid back in full during the individual’s lifetime. C. Life Estate

Life estate is a limited interest in real property. A life estate holder does not have full title to the property but has the right to use the property for their lifetime or for a specified period.

1. Exclude a life estate interest as an asset in determining eligibility for Medicaid. 2. Evaluate for transfer of assets when the a/b, or the a/b’s spouse transfers real