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North Carolina Department of Health and Human Services AGED, BLIND AND DISABLED MEDICAID MANUAL MA-2245
UNDUE HARDSHIP WAIVER FOR TRANSFER OF ASSETS
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ISSUED 11/01/07 – CHANGE NO. 24-07 (IV.)
B. Statements of knowledgeable persons, including but not limited to doctors, nurses, social workers or family members, establishing through the greater weight of evidence that the a/r will be deprived of food, clothing, shelter, or other necessities of life if a penalty period is imposed.
C. Verification that no other alternative income or assets exist to provide payment for institutional services, or food, clothing, shelter, or other necessities of life.
1. Consider the following:
a. Does the a/r have assets, both countable and non-countable, to pay for medical care, shelter, clothing, and other necessities of life?
b. Are there any other alternatives available to the a/r to provide medical care, food, clothing, shelter, and other necessities of life?
c. Does the a/r and/or a/r’s spouse, or if under age 18, a/r’s parents, have sufficient assets, including all countable and excluded assets except the individual’s, spouse’s, or parent’s home, to pay for medical care, shelter, clothing, and other necessities of life?
2. Available income means all income of the a/r and a/r’s spouse less the full amount of the maximum community spouse income allowance, including the excess shelter allowance, plus 50% of other income over the maximum community spouse income allowance for the community spouse (CSP). Any income of the CSP in excess of this amount may be a source to pay for long term care costs for the institutional spouse (ISP).
EXAMPLE: The CSP has income of $5,000/mo. Subtracting the maximum community spouse income allowance ($2,541) leaves $2,459 ($5,000 - $2,541 = $2,459). Half of the $2,459 is $1,229.50, rounded up is $1,230. Adding $1,230 to the maximum community spouse income allowance is $3,771 ($2,541 + $1,230 = $3,771). The amount of the CSP’s income over this amount, $1,229/month ($5,000 - $3,771 = $1,229), may be used to pay for the ISP’s care.
3. When the a/r or the a/r’s spouse has an equity interest in the home exceeding $500,000, the home is an alternative source to provide payment for institutional services, or food, clothing, shelter, or other necessities of life regardless of who is living in the home.