Active cases and excess resources

If excess resources were assigned but never paid and the client is still over resources in a subsequent month, you cannot assign the same excess again. The only alternative is to terminate the case.

Determine if the excess is the same funds previously assigned

If it is the same funds, do not assign them again

Find out if they have paid but it is not yet reflected in the accounts by discussing with the institution bookkeeper

If it has not been paid, advise the individual they are not eligible as their eligibility was contingent upon them paying that excess toward care

Determine if/when they are going to pay it and follow up

If individual fails to pay it after allowing a reasonable time (10 days) propose termination

Advise HQ there is a situation where an active medical institution case starts receiving Medicare coverage at 100% (nursing home readmit after a hospital stay) and has excess resources. This will be very rare and most likely will be an overpayment.

When a client becomes ineligible due to excess resources and notifies the agency timely, and the notification is beyond the time for 10 day notice to be given. We do not terminate the case. We must give 10 day notice, unless the client verbally waives the notice to prevent an overpayment. See WAC 182-518-0025 .

Example #1: 10 day notice

Client received a lump sum on 4/25/2015. They have 30 days to report and report the change of 5/10/2015. Their combined resources on 5/1/2015 were $4000. In this example we would propose termination effective 5/31/2015 and indicate if the client's resources are at or below $2000. We would need verification, see Verification requirements . We could reinstate eligibility if reported within 30 days