2-009.10B3b Period of Ineligibility

If the worker determines that an individual disposed of a resource, the applicant or recipient is ineligible for medical assistance for the number of months determined by dividing the countable value of the resource by the actual monthly cost of care in the specified living arrangement at the current private pay rate.  The period of ineligibility begins:

1. If the individual is on Medicaid, with the month of entry into a specified living arrangement; or

2. If the individual is not on Medicaid, the month of application if in a specified living arrangement.

If the individual is on Medicaid, ineligibility begins the month following the month of discovery.

The individual must be Medicaid eligible except for the deprivation of resources in the month of application. It does not apply to an application month in which the individual is ineligible because of excess resources or other eligibility criteria.

If the division results in a fraction, the worker converts the fraction to a dollar amount and includes that amount as unearned income for the applicable month.

In determining the period of ineligibility, the worker uses the fair market value of the transferred resource only.  The value of other resources and income are not included in the calculation.

For periodic disposals within the look back period, the worker determines each separately; the periods of ineligibility run consecutively.  Multiple fractional month transfers are cumulative and treated as one transfer.

The remaining time of ineligibility is divided by two and shared by the couple if the community spouse enters one of the specified living arrangements listed in 469 NAC 2-009.10B during the period of ineligibility of the institutionalized spouse.

{2/28/2007}