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Division of Welfare and Supportive Services F-225.2.2 Medical Assistance Manual HOME AND COMMUNITY BASED SERVICES 23 Oct 01 MTL 04/23 Resource Determination

4. The HCBW customer has insufficient funds to cover the cost of Home Care; and

5. Without Medicaid, the HCBW customer would be forced to go without life sustaining medical care as determined by an individual licensed to practice medicine in the State of Nevada.

Send Undue Hardship requests to the Chief of Eligibility and Payments for evaluation and decision.

h. Additional Resources Following Initial Eligibility

If the HCBW customer acquires a new countable resource following the initial eligibility determination, his/her resource eligibility must be re- evaluated.

Apply the ownership/availability rules to newly acquired resources.

Determine how much, if any, of the spousal protected resources (Line II, "e") was used to transfer resources in the community spouse's name only. If there is a balance remaining, more resources countable to the HCBW customer can be protected for the community spouse so the HCBW customer remains resource eligible.

Determine if the spousal protected resources has an unused balance in an amount equal to or more than the new resource. If not, and the excess of resources is over the resource limit, terminate Medicaid coverage allowing the appropriate adverse action time. If the balance of the spousal protected resources is enough to protect the new resource from being counted toward the resource limit, apply the transfer to community spouse provisions as outlined.

Example #1: Liquid Resources

The community spousal protected resources was determined to be $12,000. After approval, the community spouse transferred $8,600 of resources to his/her name only. This leaves a balance of $3,400 in spousal protected resources. Later, the HCBW customer receives a retroactive VA benefit check in the amount of $13,000; $10,000 remains the month after receipt and must be considered a countable resource. Since the balance of the spousal protected resources is $3,400, this is the maximum that can be protected. The difference of $6,600 ($10,000 - $3,400) remains a countable resource to the HCBW customer and renders him/her ineligible for Medicaid.