2301 Family Medicaid Resources Overview | Medicaid

Resource limits are set by federal or state law.

The resource limit for the following Family Medicaid Classes of Assistance (COA) is $1000 per AU:

Parent/Caretaker Medicaid, Pregnant Woman Medicaid, Child Under 19 Medicaid, Newborn Medicaid, TMA, Four Months Extended Medicaid (4MEx), PeachCare for Kids®, and Pathways have no resource limit.

The Family Medicaid Medically Needy (FM-MN) resource limit increases based on the number of individuals in the Budget Group (BG), as follows:

The FM-MN resource limit increases by $100 for each additional BG member.

All countable resources available to the AU are applied to the resource limit of the Family Medicaid COA.

If the total countable resources are less than or equal to the resource limit, the AU is eligible based on resources.

If the countable resources exceed the resource limit for a Family Medicaid COA, the AU is ineligible for that COA.

For Family Medicaid COAs, if resources of the BG are within the applicable limit at any time during a month, the AU is resource eligible for that month.

Eligibility based on resources is determined by resolving the following questions:

Resources are considered liquid or non-liquid and are described as follows:

Resources available to an AU are used to determine eligibility at the following times:

The countable resources of the following individuals are used to determine eligibility:

It is assumed that a resource belongs to the individual in whose name it is listed unless the AU can prove otherwise.

The burden of proof in establishing that a resource does not belong to an individual rests with the AU.

Convincing evidence such as the following must be provided to rebut ownership:

A resource that is jointly owned with a non-AU or non-BG member is considered available to the Family Medicaid AU or BG in its entirety if the following conditions apply:

A resource which is jointly owned with a non-AU or non-BG member is excluded if all of the following apply:

A portion of a jointly owned resource is included if the AU or BG has access to and may dispose of a portion of the resource.

If a resource is owned by individuals receiving Medicaid in different AUs, the resource is considered available to each owner in equal shares.

The balance of a jointly owned bank account is divided among the individual owners.

A resource is considered available when the AU or BG has the legal right to liquidate the resource and to use the proceeds.

Resources that are inaccessible to the AU or BG or which AU or BG cannot legally liquidate are excluded.

Examples of excluded resources include the following:

Bankruptcy is a condition whereas a debtor, either voluntarily or invoked by a creditor, is judged legally insolvent and the debtor’s remaining property is administered and distributed to his/her creditors.

The AU’s resources are included or excluded depending on their accessibility and the AU’s ability to liquidate the resource and retain the proceeds.

Refer to 2399 Treatment of Resources by Resource Type Chart.

Excluded income that is retained as a resource the month following the month the income was received is counted as a resource.

Only those resources that are available to the AU at the time that eligibility is determined are counted.

Excluded resources may be commingled with countable resources. The excluded resources retain its exclusion for six months from the date the resources were commingled. Beginning in the seventh month following the commingling of funds, the asset’s value is counted in its entirety.

In the event an excluded resource is converted to a countable resource, the value of the resource is applied to the appropriate resource limit in the month the resource is converted.

If a countable resource is converted to cash, the value of the cash is countable toward the appropriate resource limit.

Money received from a third party, such as an insurance company that is intended to cover the replacement or repair of a resource is excluded based on the guidelines below:

Any amount not used for the specific replacement or repair is considered income to the AU. Any unused amount that exceeds the FPL is budgeted as a lump sum in the month received.

The most current available information is used to verify the value of a resource in determining eligibility.

Sources which may be used to determine value include the following:

The appreciation or depreciation of a non-liquid resource is considered in determining the value of the resource.

Appreciation is an increase in the value of a resource due to of any of the following:

Appreciation is determined by obtaining verification from a knowledgeable source. Depreciation is a decrease in the value of a resource due to any of the following:

Depreciation is determined by obtaining verification from a reliable source.

The value of a resource is determined by using one of the following:

A transfer of resources includes selling, swapping, trading, or giving away a countable resource for less than the FMV.

In Family Medicaid Classes of Assistance (COAs), there is no penalty for transferring resources. Only resources owned by the AU at the time of the eligibility determination are considered.

Follow the steps below to determine whether or not the AU or BG meets the resource limit: