Page 5

5

3. Liquid assets: such as annuities and certain life insurance policies without a living beneficiary.

4. For individuals with a qualified Long - Term Care Partnership policy, assets subject to estate recovery include all of the above and assets owned by the a/b immediately prior to death, including:  All real and personal property available for the discharge of debt in which the beneficiary had any legal interest at the time of death.  Assets conveyed to a survivor, heir, or assignee.  Life estates and living trusts.  Ownership interests in joint tenancy with rights of survivorship  Tenancy-In-Common  Any other arrangement

III. ESTATE RECOVERY PROCEDURES AT APPLICATION AND RECERTIFICATION

A. Notification Procedures – at Application:

1. Caseworkers must explain Estate Recovery to applicants during telephone or in-person interviews.

2. The forms DHB-5051/DHB-5051sp, DHB-5052/DHB-5052sp, and DHB- 5052SA/DHB-5052SA-sp can be generated manually if requested by the applicant,

 Via NC FAST pro-forma,  or via the NC DHHS Forms Library link for each form.

3. Caseworkers are not required to generate these forms at application. When an application for Medicaid (PLA, LTC, SA, CAP, or PACE) is approved, DocuSign Envelope ID: FDC5A36F-C20D-40ED-8E94-3167F2A747A6 DocuSign Envelope ID: 9CB30F35-4CFE-41A3-8663-00DA59A946C6

loading…

Page 5

Official source

5

3. Liquid assets: such as annuities and certain life insurance policies without a living beneficiary.

4. For individuals with a qualified Long - Term Care Partnership policy, assets subject to estate recovery include all of the above and assets owned by the a/b immediately prior to death, including:  All real and personal property available for the discharge of debt in which the beneficiary had any legal interest at the time of death.  Assets conveyed to a survivor, heir, or assignee.  Life estates and living trusts.  Ownership interests in joint tenancy with rights of survivorship  Tenancy-In-Common  Any other arrangement

III. ESTATE RECOVERY PROCEDURES AT APPLICATION AND RECERTIFICATION

A. Notification Procedures – at Application:

1. Caseworkers must explain Estate Recovery to applicants during telephone or in-person interviews.

2. The forms DHB-5051/DHB-5051sp, DHB-5052/DHB-5052sp, and DHB- 5052SA/DHB-5052SA-sp can be generated manually if requested by the applicant,

 Via NC FAST pro-forma,  or via the NC DHHS Forms Library link for each form.

3. Caseworkers are not required to generate these forms at application. When an application for Medicaid (PLA, LTC, SA, CAP, or PACE) is approved, DocuSign Envelope ID: FDC5A36F-C20D-40ED-8E94-3167F2A747A6 DocuSign Envelope ID: 9CB30F35-4CFE-41A3-8663-00DA59A946C6