Eligibility Online Manual

Table 8- Countable/Available Resources

 

Effective Date:  January 1, 2024

 

Achieving a Better Life Experience (ABLE) Accounts:

1.     Exempt funds in an ABLE account, when set up in any state that has approved for these accounts to be set up in Wyoming. The Governor's Council on Developmental Disabilities administers the ABLE accounts and determines if the individual meets the following criteria:

a.                       Eligible for Supplemental Security Income (SSI) based on disability or blindness that began before age 26;

b.                      Entitled to disability insurance benefits, childhood disability benefits or widow's or widower's benefits before age 26; OR

c.                       Someone who has certified, or whose parent or guardian has certified that he or she:

d.                      May contribute up to $18,000 to an ABLE account per year. When employed an additional $14,580 of income may be contributed to an ABLE account per year if not participating in an employer sponsored retirement option.

 

2.     Exempt any amount retained, the first of the following month, when the payment from the ABLE account can be identified as a Qualified Disability Expense.  Refer to Section 200 for Definition of ABLE accounts and Expenses.

 

3.     Nonexempt – Count the amount retained, the first of the following month, when the payment from the ABLE account is identified as a Qualified Disability Related Housing Expense.  Refer to Section 200 for Definition of ABLE accounts and Expenses.

Advanced Earned Income Tax Credit (AEITC):

Exempt as a resource for 12 months from the date of receipt.

 

 Nonexempt - Count the balance and subtract any legal encumbrances.

 

 Agreement in Escrow:


Nonexempt - Count the balance and subtract any legal encumbrances.

 

Annuities:


1. Nonexempt - Count any portion available to the client.


2.  Exempt an annuity that was sold by a bank, insurance company, or other individual engaged in business of the sale of commercial annuities and the annuity is either:

a.     An individual retirement annuity; or

b.    A deemed Individual Retirement Account (IRA) under a qualified employer, or

c.     An annuity purchased with proceeds from one of the following:

3.  Exempt an annuity purchased by the individual when set up on or after July 1, 2006 and meets the following criteria:

a.     Irrevocable;

b.  Pays out the principal and interest in equal monthly payments to the individual and is within the individual's life expectancy according to the Actuarial Life Table. Access the Actuarial Life Table through the official Social Security website at https://www.ssa.gov/OACT/STATS/table4c6.html.

c.     Names the State of Wyoming, Department of Health, as the residual beneficiary of funds remaining in the annuity, not to exceed any Medicaid funds expended on the individual during his/her lifetime, unless there is a community spouse and/or a minor or disabled child, then the State of Wyoming can be named as the secondary beneficiary; and

d.    Issued by an insurance company licensed and approved to do business in the State of Wyoming.

e.     A transfer at less than FMV has occurred and needs to be determined when the annuity is not available to the individual, does not meet the exemption criteria and was transferred within the 60 month look back period.

A transfer at less than FMV has occurred if the life expectancy of the client is less than the life of the annuity, or the annuity is set up on or after November 1, 2004 and contains a balloon, back load or lump sum payment: if the following:

a.     The life expectancy of the client is less than the life of the annuity, or;

b.    The annuity was set up on or after November 1, 2004 and;

c.     Contains a balloon, back load or lump sum payment and was transferred within the 60 month look back period;

d.    The value of the transfer is the difference of the life of the annuity and the life expectancy and/or;

e.     The amount of the lump sum, back load or balloon payment.

f. Determine the delayed period of eligibility, referrefer to Section M804.

 

Example - How to determine the value of the transfer:

 

Male at age 80 has purchased an annuity for $12,000 to pay out at $100 a month for 10 years. His life expectancy is 8.13 years. The money was transferred into the annuity at less than FMV because of the life of the annuity is greater than the life expectancy. The remainder of the 1.87 or 22 months of payments, in the amount of $2,250 is the value of the transfer.

Antiques/Collectibles

Nonexempt  - Count the average of two appraisals/estimates of the FMV and subtract any legal encumbrances.

Burial Funds

1.    Exempt $1,500 of burial funds in revocable burial contracts, certificate of deposits, bank accounts or other financial instruments. There is only one $1,500 exclusion for all funds set aside for burial. The burial fund must meet the following criteria to be exempt:

a.  Burial funds are clearly designated and set aside for burial expenses for each person in the assistance unit.

b.  Burial funds are kept separate from funds that are not intended for burial. If burial funds are mixed with other resources, not intended for burial, no portion of the funds are exempt.

2. Exempt interest earned on burial funds when the fund was under the $1,500 at the time it was set aside for burial and has gained interest over time causing the fund to be over $1,500.

3. Exempt  irrevocable burial contracts when the client cannot revoke, dissolve or cancel the contract for any reason.

4. Exempt revocable burial trust, when there is an amendment in writing on the trust stating “I wish to make this an irrevocable trust” initialed by both the funeral home and the client or representative and dated.

5. Exempt a life insurance policy when ownership has been irrevocably assigned to a funeral home.

6. A transfer at less than Fair Market Value has occurred when the goods and services purchased from the funeral home is less than the cash surrender value of the Life Insurance policy.

a.  The value of the transfer is the difference of the value of the life insurance and the amount of goods and services purchased from the funeral home.

b.  Determine the delayed period of eligibility, refer to Section M804.

Burial Plot

1.    Exempt the value of all burial plots for the Medicare Savings Programs.

2.    Exempt one for each person in the household assistance unit.

Burial Space Items

1.   Exempt burial space items in an agreement, including any accumulated interest, when the purchase amount is paid in full.

2.   Apply this exemption to burial spaces held for the client, client's spouse or any member of the client's immediate family.

Cash App Platforms

Nonexempt - Count cash value.

Cash Gifts

Nonexempt - Consider any money remaining the first of the following month as a resource.

Certificates of Deposit

Nonexempt - Count cash value after deducting any legal encumbrances.

Checking Accounts

Nonexempt - Count cash value after deducting any legal encumbrances.

Deduct any outstanding checks written and delivered to the payee prior to the first of the month that have not cleared, when the individual is over the resource limit.

Commingled Funds

Nonexempt - When previously exempt funds are commingled with nonexempt funds.

Contract for Deeds

Nonexempt - Count the unpaid principal balance and subtract any legal encumbrances.

Refer to Medicaid Table 2 for treatment of income.

Crypto Currency

Nonexempt - Count cash value.

Earned Income Tax Credit (EITC)

Exempt - As a resource for 12 months from the date of receipt.

Educational Funds

Exempt - Educational loans, grants and scholarships which are designated for educational purposes only and not commingled with other nonexempt funds.

GoFundMe, Fundraiser or Donations

Nonexempt - Consider any money remaining, the first of the following month after receipt, as a resource.

Home

An individual's home is property in which they have an ownership interest and that serves as their principal place of residence. It can include any of the following:

a. The shelter in which they live.

b. The land on which the shelter is located.

c. Related buildings on such land.

d. Lots that share the same property line as the land on which the shelter is located.

1.  Exempt the home, regardless of the equity value for the Medicare Savings Programs, Inpatient Hospital Care, and Hospice.

2.  Exempt – the home, regardless of the equity value when lived in by the client’s spouse, a child under the age of 21 who is blind or disabled, or an adult disabled child.

3.  Exempt the home when the equity value is at or below the Home Equity Limit listed in Medicaid Table 7 and is lived in by the client, the client's spouse, a child under the age of  21 who is blind or disabled or the dependent(s).

4.  Exempt the home when the equity value is at or below the Home Equity Limit listed in Medicaid Table 7 and it is not lived in by the client, client's spouse, a child under the age 21 who is blind or disabled or a dependent, and the individual has completed and signed a Statement of Intent to Return Home (DHCF-302).

5.  Exempt property when a bona fide effort to sell is made and the client meets all of the following criteria:

a. Has been institutionalized and eligible for Medicaid for six or more months.

b. Has entered into a written agreement (contract) with the WDH regarding the proceeds of the sale of the property.

c. Pays the net proceeds of the sale to the WDH to reimburse medical assistance payments made on their behalf.

d. If the net proceeds exceed the amount of paid Medicaid benefits, a period of ineligibility will exist until the client has spent down the funds. 

6.  Exempt - property when the client makes a reasonable effort to sell property throughout a 9-month period of conditional benefits and provides the following:

a. Agreement to Sell Property (DHCF-500) is complete and signed by the applicant, POA, guardian/conservator or Attorney-In-Fact and WDH Program Manager.

b. Documentation to show the property is up for sale:

■      Copy of the listing agreement with the real estate agency in current use;

■      Dated advertisement(s) indicating the property is for sale;

■      Contracts with the media to advertise the property;

■      A photograph of the "For Sale" sign on the property;

■      Copies of fliers or posted notices; or

■      Any other evidence of reasonable efforts to sell property.

c. Provide a copy of the approved Agreement to Sell Property to the Estate Recovery Specialist.

d. Reevaluate the exempt status in 6 months to verify the client continues to make a reasonable effort to sell the property and obtain documentation.

e. Reevaluate the exempt status at the end of the 9-month conditional benefit period, to verify the client continues to make a reasonable effort to sell the property, and obtain documentation.

■      Continue to exempt property with the original Conditional Benefit Agreement, after the 9-month Conditional Benefits period, when the client continues to make a reasonable effort to sell the property and has provided verification.

■      Reevaluate the exempt status every 6 months to verify the client continues to make reasonable efforts to sell the property and obtain verification.

f. Property is non-exempt when it is determined by DHCF that the client is not making a reasonable effort to sell the property.

g. Notify the Estate Recovery Specialist to initiate the process of seeking reimbursement for DHCF, when the property is sold or the client is not making a reasonable effort to sell the property.

 

7.   The home, including all connected land and buildings, is Nonexempt when it is not lived in by the client, client's spouse or dependent(s) and the individual has not completed an Agreement to Sell Property (DHCF-500)

 

8.   Evaluate as a resource under income producing property when a building connected to the home property is rented.

 

9. Verify ownership of the home property at each yearly review.

Consider a rental payment as income when the exempt home is rented. The rental income, less rental expenses, is divided by the number of owners to arrive at the client's portion of the income.

Home Replacement Funds

Exempt the proceeds of the sale of an excluded home if the individual:

a.  Plans to use the proceeds from the sale of the home to buy another excluded home, and

b.  Uses the money to purchase a home within 3 full calendar months of receiving the proceeds.

Household Furnishings/Goods and Personal Effects

1.   Exempt one wedding ring and one engagement ring per individual regardless of value.

2.   Exempt items needed for medical or physical health conditions if they are not used extensively/primarily by other members of the assistance unit.

3.   Exempt up to $2,000 total equity value of other household furnishings/goods and other personal effects not listed above.

4.   Accept the client's statement when there is not evidence to the contrary.

Individual Indian Monies (IIM) Account (restricted)

Exempt IIMs when only monies listed under P.L. are deposited and BIA authorization is required to withdraw or use the deposited funds. Following are the IIM accounts which can be exempted:

All judgment funds/Funds held in trust:

 

Funds held in trust:


Judgment Funds:

 

Payments/Funds held in trust:

●      Grand River Band of Ottawa Indians

●      Leech Lake reservation, Minnesota

●      Miccosukee Tribe, Florida (under $2,000)

●      Mille Lac Reservation, Minnesota

●      Puyallup Tribe of Indians Settlement Act, Washington

●      Saginaw Chippewa Indian Tribe, Michigan

●      Seminole Nation, Oklahoma (under $2,000)

●      Seminole Tribe, Florida (under $2,000)

●      Seneca Nation Settlement Act

●  White Earth Reservation Land Settlement Act, Minnesota

Income Producing Property

1.   Exempt up to $6,000 equity for income producing property essential to an individual's means of self-support if the property produces a rate of net annual return equal to at least 6% of the equity value.

2.   Nonexempt - Count any portion of the property's equity value in excess of $6,000.

3.   Continue the exemption if a property produces less than the 6% return but there is a reasonable expectation the property will resume the 6% production within the next 24 months.

Inheritance

Nonexempt - Count the cash or FMV when it is still available the first day of the following month.

Joint Bank Account w/Non-Assistance Unit Member

Nonexempt - In the month following the month of deposit when the client can legally withdraw the funds.

Land, Buildings and Other Real Property

(See Income producing property)

Nonexempt - Count the Fair Market Value (FMV) which is the selling price on the open market as set by current standards. FMV may be determined by a market analysis or appraisal by a realtor, or other knowledgeable sources who are familiar with property values in a given community and subtract any legal encumbrances.

Exempt the value of an individual's ownership interest in jointly owned real property for as long as the sale of the property would cause undue hardship, due to loss of housing to a co-owner.

Undue hardship exists when co-owner provides a signed statement to the following:

1.    Use the property as his or her principal place of residence; and

2.    would have to move if the property were sold; and

3.    has no other readily available housing.

 

For the purposes of determining financial eligibility, when the applicant/client has the legal right, authority, or power to liquidate the real property in which they hold a fractional interest, the valuation will be calculated as follows:

1.    Start with the appraised value of the property, e.g. $314,000.

2.    Find the value of proportional share(s) for the individuals whose ownership interest qualify as a resource to be used by the applicant/client for establishing eligibility, e.g. 7/16 of the total value $137,375.

3.   Apply a discount reflecting that the interest owned by the applicant/client is not whole, but fractional.

a.     For those with a minority interest of less than 50% ownership in the real property apply a 30% discount, e.g. $137,375 x .70 or $96,162.50 is the applicant/client’s real property valuation.

b.    For those with a majority interest of 50% or more ownership in the real property apply a 20% discount, e.g. $137,375 x .80 or $109,900 is the applicant/client’s real property valuation.

4.    The fractional interest discount does not apply for estate recovery purposes.

 

Life Estate

1.   If the client retains the power to sell the property, determine the equity value to be compared to the resource limit.

2.    If the client does not retain the power to sell the property, determine if the life estate was transferred at FMV, refer to Medicaid Table 11. Apply the penalty period due to a nonexempt transfer when the life estate was not transferred at FMV.  Refer to Section 804.

3.  If the applicant/recipient purchases a life estate interest in another individual's home and has lived in the home for a period of at least one year after the date of purchase, determine if the life estate was transferred at FMV, refer to Medicaid Table 11.

4.    If the applicant/recipient purchases a life estate interest in another individual's home and does not live in the home for a period of at least one year after the date of purchase, the amount of the transfer is the entire amount used to purchase the life estate. Refer to Section M804 for instructions on figuring the penalty.

Life Insurance

1.   Exempt the cash surrender value of all life insurance policy for the Medicare Savings Programs.

2.   Exempt a life insurance policy, or, if the client(s) owns more than one policy, combination of policies when:

a.   The insurance is term insurance and does not generate a cash surrender value; or

b.   The combined face value of all policies does not exceed $1,500.

3.   Exempt life insurance policies that are designated for burial and meet the exempt criteria under the Burial Funds policy.

4.   Exempt the cash surrender value when the combined face values of all policies do not exceed $1,500.

Livestock, Farm Machinery, Tools

Nonexempt - Count the average of two appraisals/estimates of the FMV and subtract any legal encumbrances when not used for self-support.

Exempt livestock when used for consumption in the individual's household or they are considered a pet of the household.

Loans

Exempt as income in the month of receipt. Consider any money remaining the first of the following month as a resource.

Lump Sum

Nonexempt - Consider any money remaining the first of the following month as a resource.

Medicare Set-Aside (MSA) Account

Exempt Medicare Set-Aside (MSA) Account. Refer to Section 200 for Definition of MSA accounts.

Mineral Rights

Exempt the value of mineral rights on land that is being excluded under the home exemption.

Nonexempt - Current market value of the land, includes the value of the mineral rights when owned by the individual.

Nonexempt - Count the CMV of the mineral rights when the land is not owned by the individual.

Obtain a current market value estimate from a knowledgeable sources or calculate the value of the mineral right by using the Royalty calculator. Some of the knowledgeable sources and Royalty Calculators are listed below:

a.     Bureau of Land Management

b.    U.S. Geological Survey

c.     Any mining company that holds leases

d.    Real estate brokers;

e.     Banks, savings and loan associations, mortgage companies, and similar lending institutions

f.      Local office of the Farmer's Home Administration (for rural land);

g.     Local office of the Agricultural Stabilization and Conservation Service (for rural land);

h.    Official of the local property tax jurisdiction (be sure to obtain the official's estimate rather than the office's assessment); and

i.       County Agricultural Extension Service.

j.       Calculate the value of the mineral rights by entering the average monthly royalty income on the Royalty Calculator from the websites below, using the 4 years of production value:

PASS Account

Exempt as a resource and any income deposited into the account is exempt.

Personal Care Contract

1.   A “Personal Care Contract” (PCC) is an agreement between a caregiver and an individual to provide caregiver services for fair market value.

2.   Payments made to family members through a PCC to delay or prevent entrance into a long term care facility are considered transfers for fair market value. Fair market value can be verified through the U.S. Department of Labor, Bureau of Labor Statistics Occupational Outlook Handbook at:
 https://www.bls.gov/ooh/healthcare/home-health-aides-and-personal-care-aides.htm.

3. The written agreement must contain the following information:

a.     The date the care begins,

b.    A detailed description of the services to be provided,

c.     How often services will be provided,

d.    How much the caregiver will be compensated,

e.     When the caregiver will be compensated,

f.      How long the agreement is to be in effect,

g.     A statement that the terms of the agreement can be modified only by mutual agreement of the parties,

h.    The location where services will be provided, and

i.       The notarized signature of both parties.

4. The following services may be provided through a PCC:

a.  Preparing meals

b.  Shopping

c.  Medication management

d. Transportation to medical appointments

e.  Paying bills

f.  Light housekeeping

 g.    Assistance with activities of daily living.

5. The applicant or client must provide a detailed log to clearly identify the services provided under the PCC.The logs must include the date, time, amount paid, and services provided.

6.   No services may be provided under a PCC while an individual resides in a long term care facility or receives services under a Waiver program. Advocating for services are not an allowable service under the PCC.

7.   A caregiver may not duplicate services provided by a home health aide, nurse, medical professional, or other care provider hired to assist the applicant or client.

Promissory Note, Loan or Mortgage

Exempt funds used to purchase a promissory note, loan, or mortgage when it meets the following criteria:

1.  Repayment term is actuarially sound (pays out within the   individuals life expectancy). Refer to https://www.ssa.gov/OACT/STATS/table4c6.html to access the Actuarial Life Table through the official Social Security website.

 

 

2.    Provides for payments to be made in equal amounts during the term of the loan, with no deferral or balloon payments; and

 3.    Prohibits the cancellation upon the death of the lender.

 

Nonexempt - Count the unpaid outstanding principal balance and subtract any legal encumbrances as of the date of the individual's application, when the promissory note, loan or mortgage does not meet the exemption criteria.

 

Example - How to determine if the promissory note is actuarially sound:

 

A female at age 80 purchases a promissory note for $10,800 to pay out at $100 a month for 9  years. Her life expectancy is 9.58 years and is less than repayment term on the promissory note. The promissory note is actuarially sound.

 

Refer to Medicaid Table 2 for treatment of income.

Property Used for Self-Employment

Exempt property essential to the self-employment business.

Qualified Long Term Care Insurance Partnership

Exempt resources equal to the amount of the Qualified Long Term Care Insurance Partnership benefit payments, made to or on behalf of the individual. Refer to Section M801 for instructions on how to determine if the policy is a Qualified Long Term Care Insurance Partnership and how to exempt the resources.

Radiation Exposure Compensation Payments

Exempt unspent, including interest earned, are exempt as a resource.

Recreational Vehicles

Exempt the value of a recreational vehicle, with a motor, for the Medicare Savings Programs.

Nonexempt - Use the equity value of any recreational vehicles and apply the value toward the resource limit.

Reimbursement for Medical Expenses

Exempt - reimbursement for medical expenses when the client has already paid the bill.

Consider the remaining reimbursement as a resource on the first day of the month following the month of receipt.

Resource Replacement

Exempt any governmental payments which are designated for restoration of a home damaged in a disaster when the assistance unit must legally use the funds for that purpose.

1.    Exempt cash and in-kind receipts from any source for the repair or replacement of an exempt resource which is lost, damaged or stolen for nine months from the date of receipt as long as the funds are not commingled.

2.    Exempt - the interest earned on this money.

3.    Planned use of the funds does not affect the exemption for the first nine months.

4.    Reevaluate as an exempt or nonexempt resource when the money is used to purchase a resource other than what was or was to be repaired or replaced.

5.    Count the cash and interest earned on the cash when it is still available at the end of nine months.

Retirement/Pension Plans/Funds

Nonexempt - Count the cash value stated by the employer, company, or financial institution when the client has the authority to withdraw the funds.

Exempt pension/retirement funds not available or belonging to an ineligible spouse.

Retroactive RSDI and SSI Payments

Exempt retroactive RSDI and SSI payments for the first nine months following the month in which the individual receives the benefits.

Nonexempt - Count any retroactive RSDI and SSI payment remaining, after the nine month period, as of the first day of the tenth month after the month of receipt.

Reverse Mortgage

(See Income Table)

Nonexempt - Count loan proceeds retained by the client beyond the month in which the funds are received as a resource the first of the following month. 

Savings Accounts

Nonexempt - Count cash value after deducting any legal encumbrances.

Savings Bonds

Nonexempt - Count the current cash value of U.S. Savings Bonds and Treasury Notes. (The value can be obtained by contacting a local bank.)

      Stocks, Mutual Fund Shares, Money Market Certificates, Bonds

 

    Nonexempt - Count the CMV as of the first moment of a given month.

 

The closing price on the last business day of the preceding month is the CMV. The value canbe obtained from the published quotations in daily newspapers or local securities firm.

Tax Refund (Federal)

Exempt as a resource for 12 months from the date of receipt.

Tax Refund to Elderly and Disabled

Exempt during the month of receipt and count the remaining amount of the tax refund to the elderly and disabled as a resource on the first day of the month following the month of receipt for Medicaid.

Trust Funds

Nonexempt - Count the cash value when the applicant/recipient has a legal interest or has the legal ability to make the funds available to meet day-to-day needs or the funds can be made available upon request. Refer to Section M805.

Vehicles – Licensed

1.   Exempt the value of vehicles, with a motor, for the Medicare Savings Programs.

2.    Exempt one vehicle regardless of value if it is:

a.  Necessary for employment.

   b.  Necessary for the treatment of a specific or regular medical problem.

c.  Modified for operation by, or the transportation of, a handicapped person.

   d.  Necessary for the performance of essential daily activities.

3.    Exempt any vehicle used in a trade or a business.

Vehicles – Unlicensed

1.   Exempt the value of all unlicensed vehicles, with a motor, for the Medicare Savings Programs.

2.   Exempt up to $4,500 of the trade-in value of one vehicle when not exempt.

3.   Use the equity value of any additional vehicles and apply the value toward the resources limit.

Vehicles – Leased

Exempt during the contract or agreement period. If purchased, treat as a licensed/unlicensed vehicle, as appropriate.

Veterans Aid and Attendance (A & A)

Nonexempt - Count any money retained, as of the first moment of the following the month of receipt, as a resource.