Section 405 IAC 2-3-15 - Resources; limitations and exclusionsAuthority: IC 12-15
Affected: IC 12-13-7-3; IC 12-15
Sec. 15.
(a) An applicant or recipient is ineligible for medical assistance for any month in which the total equity value of all nonexempt personal property exceeds the applicable limitation, set forth as follows, on the first day of the month: (1) One thousand five hundred dollars ($1,500) for the applicant or recipient, including the amount determined in subsection (b), or in addition to the amount determined in subdivision (3), if applicable.(2) Two thousand two hundred fifty dollars ($2,250) for the applicant or recipient and his or her spouse if the couple is living together, or if the most recent continuous period of institutionalization of one (1) member of the couple began prior to September 30, 1989.
(3) Twelve thousand dollars ($12,000), subject to adjustment under Section 1924(g) ofthe Social Security Act, as the spousal resource standard provided for in Section 1924(f)(2)(A)(i) of the Social Security Act, or a higher amount as determined under: (A) Section 1924(f)(2)(A)(ii);(B) Section 1924(f)(2)(A)(iii); or(C) Section 1924(f)(2)(A)(iv); of the Social Security Act for a community spouse as defined in Section 1924(h) of the Social Security Act.
(b) Except as provided in subdivision (3), if the applicant or recipient is under eighteen (18) years of age, his or her personal property includes the value of his or her parents' personal property in excess of the following limitations and in the following situations:(1) If the child lives with one (1) parent, one thousand five hundred dollars ($1,500) of the parent's personal property is excluded. If the child lives with two (2) parents, two thousand two hundred fifty dollars ($2,250) of the parents' personal property is excluded.(2) If the child is institutionalized, one thousand five hundred dollars ($1,500) of the personal property of his or her custodial parent or two thousand two hundred fifty dollars ($2,250) of the personal property of both parents is excluded.(3) If the child is approved for home and community based services under the waiver for persons with autism, in accordance with 42 U.S.C. 1396 n, parental resources are excluded regardless of parental income.(c) In determining eligibility of an individual applying for medical assistance with respect to nursing facility services or other long-term care services, the individual shall not be eligible for such assistance if the individual's equity interest in the individual's home exceeds five hundred thousand dollars ($500,000). The dollar amount specified in this subsection shall be increased beginning with 2011, from year to year, in accordance with federal law. The limitation in this subsection shall not apply if:(1) the individual's spouse or dependent child under the age of twenty-one (21), or blind or disabled child lawfully resides in the home;(2) a reverse mortgage or home equity loan has reduced the individual's equity interest in the home below the equity interest restriction;(3) the individual purchased a long-term care insurance policy that will protect the excess home equity;(4) the individual can prove through the process in section 24 of this rule that the application of this subsection will create a hardship for the individual under the standards stated in that rule.(d) In addition to that property required to be excluded by federal statute or regulation, the following property is exempt from consideration: (1) All household goods and personal effects.(2) Personal property required by an individual's employer while the individual is employed.(3) The equity value of personal property used to produce food for home consumption or used in the production of income.(4) The value of life insurance with a total face value of one thousand four hundred dollars ($1,400) or less if provision has been made for payment of the applicant's or recipient's funeral expenses from the proceeds of such insurance. However, the one thousand four hundred dollars ($1,400) limitation shall be reduced by any amount in an irrevocable burial trust or irrevocable prepaid funeral agreement.(5) For a period of not more than nine (9) months from the date of receipt, the proceeds or any interest earned on the proceeds of casualty insurance received as a result of damage, destruction, loss, or theft of exempt real or personal property if the applicant or recipient demonstrates that the proceeds are being used to repair or replace the damaged, destroyed, lost, or stolen exempt property.(6) One (1) motor vehicle according to the following provisions:(A) One (1) motor vehicle is excluded, regardless of value, if, for the applicant or recipient or other member of his or her household, the motor vehicle is: (i) necessary for employment;(ii) necessary for the medical treatment of a specific or regular medical problem; or(iii) modified for operation by or transportation of a handicapped person.(B) If no motor vehicle is excluded under clause (A), four thousand five hundred dollars ($4,500) of the current market value of one (1) motor vehicle is excluded.(8) Subject to the requirements in subsection (e), the home that is the principal place of residence of the: (A) applicant or recipient;(B) spouse of the applicant or recipient;(C) parent or parents of the applicant or recipient;(D) applicant's or recipient's biological or adoptive child or children under eighteen (18) years of age; or(E) applicant's or recipient's blind or disabled biological or adoptive child or children eighteen (18) years of age or older.(9) For an applicant or recipient of medical assistance under the blind category, an amount of his or her resources, as specified in an approved plan for achieving self-support, is disregarded for a period of time not to exceed twelve (12) months. Such a plan will be approved by the division of family resources in conjunction with the Indiana division of services for the blind if the plan is in writing and fully documents that the resources to be disregarded will be used by the applicant or recipient in pursuing a bona fide activity aimed at achieving self-support.(10) Income-producing real property if the income is greater than the expenses of ownership.(e) The home exempted by subsection (d)(8) is exempt until such time as it is verified that none of the persons listed in subsection (d)(8) intends to reside there. The home is the shelter in which the person resides, the land on which the shelter is located, and related outbuildings.(f) As a condition of eligibility for medical assistance for the aged, blind, and disabled, each applicant and recipient and his or her legally responsible relatives must sign an agreement to offer for sale or for rent all nonexempt real property that he or she or his or her legally responsible relatives own, except in those situations involving a community spouse and an institutionalized spouse, as defined in Section 1924(h) of the Social Security Act, wherein the total equity value of all resources of the couple does not exceed the sum of the institutionalized spouse's resource limitation specified in subsection (a)(1) and the community spouse resource standard, as determined under Section 1924(f)(2)(A) of the Social Security Act.(g) If nonexempt real property is not offered for sale or for rent at current market value within thirty (30) days of written notification of medical assistance or within thirty (30) days after the agreement referenced in subsection (f) is signed, whichever is later, the recipient shall be ineligible for medical assistance.Office of the Secretary of Family and Social Services; 405 IAC 2-3-15; filed Dec 16, 1986, 11:00 a.m.: 10 IR 1080, eff Feb 1, 1987; filed Jul 16, 1987, 2:00 p.m.: 10 IR 2670; errata, 11 IR 96; filed Jun 30, 1989, 5:00 p.m.: 12 IR 2048; filed Dec 15, 1989, 11:50 a.m.: 13 IR 878; filed Aug 21, 1996, 2:00 p.m.: 20 IR 13; readopted filed Jun 27, 2001, 9:40 a.m.: 24 IR 3822; readopted filed Sep 19, 2007, 12:16 p.m.: 20071010-IR-405070311RFA; filed Aug 18, 2009, 11:33 a.m.: 20090916-IR-405080325FRA; readopted filed Oct 28, 2013, 3:18 p.m.: 20131127-IR- 405130241RFATransferred from the Division of Family and Children ( 470 IAC 9.1-3-17) to the Office ofthe Secretary of Family and Social Services ( 405 IAC 2-3-15) by P.L. 9-1991, SECTION 131, effective January 1, 1992.