Conn. Gen. Stat. § 17b-261

Current with legislation from the 2024 Regular and Special Sessions.

Section 17b-261 - (Formerly Sec. 17-134b). Medicaid. Eligibility. Assets. Waiver from federal law

(a) Medical assistance shall be provided for any otherwise eligible person (1) whose income, including any available support from legally liable relatives and the income of the person's spouse or dependent child, is not more than one hundred fifty-nine per cent, pending approval of a federal waiver applied for pursuant to subsection (e) of this section, of the benefit amount paid to a person with no income under the temporary family assistance program and (2) if such person is an institutionalized individual as defined in Section 1917 of the Social Security Act, 42 USC 1396p(h)(3), and has not made an assignment or transfer or other disposition of property for less than fair market value for the purpose of establishing eligibility for benefits or assistance under this section. Any such disposition shall be treated in accordance with Section 1917(c) of the Social Security Act, 42 USC 1396p(c). Any disposition of property made on behalf of an applicant or recipient or the spouse of an applicant or recipient by a guardian, conservator, person authorized to make such disposition pursuant to a power of attorney or other person so authorized by law shall be attributed to such applicant, recipient or spouse. A disposition of property ordered by a court shall be evaluated in accordance with the standards applied to any other such disposition for the purpose of determining eligibility. The commissioner shall establish the standards for eligibility for medical assistance at one hundred fifty-nine per cent of the benefit amount paid to a household of equal size with no income under the temporary family assistance program. In determining eligibility, the commissioner shall not consider as income Aid and Attendance pension benefits granted to a veteran, as defined in section 27-103, or the surviving spouse of such veteran. Except as provided in section 17b-277 and section 17b-292, the medical assistance program shall provide coverage to persons under the age of nineteen with household income up to one hundred ninety-six per cent of the federal poverty level without an asset limit and to persons under the age of nineteen, who qualify for coverage under Section 1931 of the Social Security Act, with household income not exceeding one hundred ninety-six per cent of the federal poverty level without an asset limit, and their parents and needy caretaker relatives, who qualify for coverage under Section 1931 of the Social Security Act, with household income not exceeding one hundred thirty-three per cent of the federal poverty level without an asset limit. Such levels shall be based on the regional differences in such benefit amount, if applicable, unless such levels based on regional differences are not in conformance with federal law. Any income in excess of the applicable amounts shall be applied as may be required by said federal law, and assistance shall be granted for the balance of the cost of authorized medical assistance. The Commissioner of Social Services shall provide applicants for assistance under this section, at the time of application, with a written statement advising them of (A) the effect of an assignment or transfer or other disposition of property on eligibility for benefits or assistance, (B) the effect that having income that exceeds the limits prescribed in this subsection will have with respect to program eligibility, and (C) the availability of, and eligibility for, services provided by the Connecticut Home Visiting System, established pursuant to section 17b-751b. For coverage dates on or after January 1, 2014, the department shall use the modified adjusted gross income financial eligibility rules set forth in Section 1902(e)(14) of the Social Security Act and the implementing regulations to determine eligibility for HUSKY A, HUSKY B and HUSKY D applicants, as defined in section 17b-290. Persons who are determined ineligible for assistance pursuant to this section shall be provided a written statement notifying such persons of their ineligibility and advising such persons of their potential eligibility for one of the other insurance affordability programs as defined in 42 CFR 435.4.

(b) For the purposes of the Medicaid program, the Commissioner of Social Services shall consider parental income and resources as available to a child under eighteen years of age who is living with his or her parents and is blind or disabled for purposes of the Medicaid program, or to any other child under twenty-one years of age who is living with his or her parents.

(c) For the purposes of determining eligibility for the Medicaid program, an available asset is one that is actually available to the applicant or one that the applicant has the legal right, authority or power to obtain or to have applied for the applicant's general or medical support. If the terms of a trust provide for the support of an applicant, the refusal of a trustee to make a distribution from the trust does not render the trust an unavailable asset. Notwithstanding the provisions of this subsection, the availability of funds in a trust or similar instrument funded in whole or in part by the applicant or the applicant's spouse shall be determined pursuant to the Omnibus Budget Reconciliation Act of 1993, 42 USC 1396p. The provisions of this subsection shall not apply to a special needs trust, as defined in 42 USC 1396p(d)(4)(A), as amended from time to time. For purposes of determining whether a beneficiary under a special needs trust, who has not received a disability determination from the Social Security Administration, is disabled, as defined in 42 USC 1382c(a)(3), the Commissioner of Social Services, or the commissioner's designee, shall independently make such determination. The commissioner shall not require such beneficiary to apply for Social Security disability benefits or obtain a disability determination from the Social Security Administration for purposes of determining whether the beneficiary is disabled.

(d) The transfer of an asset in exchange for other valuable consideration shall be allowable to the extent the value of the other valuable consideration is equal to or greater than the value of the asset transferred.

(e) The Commissioner of Social Services shall seek a waiver from federal law to permit federal financial participation for Medicaid expenditures for families with incomes of one hundred forty-three per cent of the temporary family assistance program payment standard.

(f) To the extent permitted by federal law, Medicaid eligibility shall be extended for one year to a family that becomes ineligible for medical assistance under Section 1931 of the Social Security Act due to income from employment by one of its members who is a caretaker relative or due to receipt of child support income. A family receiving extended benefits on July 1, 2005, shall receive the balance of such extended benefits, provided no such family shall receive more than twelve additional months of such benefits.

(g) An institutionalized spouse applying for Medicaid and having a spouse living in the community shall be required, to the maximum extent permitted by law, to divert income to such community spouse in order to raise the community spouse's income to the level of the minimum monthly needs allowance, as described in Section 1924 of the Social Security Act. Such diversion of income shall occur before the community spouse is allowed to retain assets in excess of the community spouse protected amount described in Section 1924 of the Social Security Act. The Commissioner of Social Services, pursuant to section 17b-10, may implement the provisions of this subsection while in the process of adopting regulations, provided the commissioner prints notice of intent to adopt the regulations in the Connecticut Law Journal within twenty days of adopting such policy. Such policy shall be valid until the time final regulations are effective.

(h) To the extent permissible under federal law, an institutionalized individual, as defined in Section 1917 of the Social Security Act, 42 USC 1396p(h)(3), shall not be determined ineligible for Medicaid solely on the basis of the cash value of a life insurance policy worth less than ten thousand dollars provided the individual is pursuing the surrender of the policy.

(i) Medical assistance shall be provided, in accordance with the provisions of subsection (e) of section 17a-6, to any child under the supervision of the Commissioner of Children and Families who is not receiving Medicaid benefits, has not yet qualified for Medicaid benefits or is otherwise ineligible for such benefits. Medical assistance shall also be provided to any child in the behavioral services program operated by the Department of Developmental Services who is not receiving Medicaid benefits, has not yet qualified for Medicaid benefits or is otherwise ineligible for benefits. To the extent practicable, the Commissioner of Children and Families and the Commissioner of Developmental Services shall apply for, or assist such child in qualifying for, the Medicaid program.

(j) The Commissioner of Social Services shall provide Early and Periodic Screening, Diagnostic and Treatment program services, as required and defined as of December 31, 2005, by 42 USC 1396a(a)(43), 42 USC 1396d(r) and 42 USC 1396d(a)(4)(B) and applicable federal regulations, to all persons who are under the age of twenty-one and otherwise eligible for medical assistance under this section.

(k) A veteran, as defined in section 27-103, and any member of his or her family, who applies for or receives assistance under the Medicaid program, shall apply for all benefits for which he or she may be eligible through the United States Department of Veterans Affairs or the United States Department of Defense.

(l) On and after January 1, 2023, and until June 30, 2024, the Commissioner of Social Services shall, within available appropriations, provide state-funded medical assistance to any child twelve years of age and younger, regardless of immigration status, (1) whose household income does not exceed two hundred one per cent of the federal poverty level without an asset limit, and (2) who does not otherwise qualify for Medicaid, the Children's Health Insurance Program, or an offer of affordable, employer-sponsored insurance, as defined in the Affordable Care Act, as an employee or a dependent of an employee. On and after July 1, 2024, the commissioner shall, within available appropriations, provide state-funded medical assistance to any child fifteen years of age and younger, regardless of immigration status, who qualifies pursuant to subdivisions (1) and (2) of this subsection. A child eligible for such assistance under this subsection shall continue to receive such assistance until such child is nineteen years of age, provided the child continues to meet the eligibility requirements prescribed in subdivisions (1) and (2) of this subsection. The provisions of section 17b-265 shall apply with respect to any medical assistance provided pursuant to this subsection.

Conn. Gen. Stat. § 17b-261

(1967, P.A. 759, S. 1(b); 1969, P.A. 730, S. 8; P.A. 78-192, S. 4, 7; P.A. 80-50; P.A. 81-214, S. 6; P.A. 85-505, S. 14, 21; 85-527; P.A. 86-363, S. 3; P.A. 87-390, S. 1, 4; P.A. 89-317, S. 1, 2; P.A. 92-233 , S. 1 ; P.A. 93-262 , S. 1 , 87 ; 93-289 , S. 1 -3; 93-435 , S. 59 , 95 ; May Sp. Sess. P.A. 94-5 , S. 16 , 30 ; P.A. 95-194 , S. 30 , 33 ; 95-351 , S. 22 , 30 ; P.A. 96-251 , S. 9 ; P.A. 97-288 , S. 3 , 6 ; June 18 Sp. Sess. P.A. 97-2 , S. 70, 165; Oct. 29 Sp. Sess. P.A. 97-1 , S. 19 , 23 ; P.A. 99-279 , S. 16 , 45 ; June Sp. Sess. P.A. 00-2, S. 18, 53; June Sp. Sess. P.A. 01-2 , S. 3 , 69 ; June Sp. Sess. P.A. 01-9 , S. 129 , 131 ; P.A. 03-2 , S. 10 ; 03-28 , S. 2 ; 03-268 , S. 7 ; June 30 Sp. Sess. P.A. 03-3, S. 63; P.A. 04-16 , S. 6 ; P.A. 05-1 , S. 1 ; 05-24 , S. 1 ; 05-43 , S. 1 ; 05-280 , S. 1 ; P.A. 06-164 , S. 3 ; 06-188 , S. 49 ; 06-196 , S. 134 , 238 , 289 ; P.A. 07-185 , S. 3 ; June Sp. Sess. P.A. 07-2 , S. 7 ; P.A. 09-8 , S. 3 ; 09-66 , S. 1 ; P.A. 10-179 , S. 66 ; P.A. 11-176 , S. 3 ; P.A. 12-208 , S. 5 ; June 12 Sp. Sess. P.A. 12-1 , S. 8 ; P.A. 13-234 , S. 127 ; P.A. 15-69 , S. 17 ; June Sp. Sess. P.A. 15-5 , S. 358 , 370 ; P.A. 16-12 , S. 1 ; 16-176 , S. 1 ; June Sp. Sess. P.A. 17-2 , S. 138 ; P.A. 18-72 , S. 29 ; 18-81 , S. 48 .)

Amended by P.A. 24-0081,S. 38 of the Connecticut Acts of the 2024 Regular Session, eff. 10/1/2024.

Amended by P.A. 24-0081,S. 39 of the Connecticut Acts of the 2024 Regular Session, eff. 5/30/2024.

Amended by P.A. 23-0204,S. 302 of the Connecticut Acts of the 2023 Regular Session, eff. 10/1/2024. (Amendment repealed per P.A. 24-0081,S. 39 of the Connecticut Acts of the 2024 Regular Session.)

Amended by P.A. 23-0204, S. 283 of the Connecticut Acts of the 2023 Regular Session, eff. 6/12/2023.

Amended by P.A. 22-0118, S. 237 of the Connecticut Acts of the 2022 Regular Session, eff. 7/1/2022.

Amended by P.A. 22-0118, S. 232 of the Connecticut Acts of the 2022 Regular Session, eff. 5/7/2022.

Amended by P.A. 21-0176, S. 1 of the Connecticut Acts of the 2021 Regular Session, eff. 10/1/2021.

Amended by P.A. 21-0172, S. 13 of the Connecticut Acts of the 2021 Regular Session, eff. 7/1/2021.

Amended by P.A. 19-0117, S. 316 of the Connecticut Acts of the 2019 Regular Session, eff. 10/1/2019.

Amended by P.A. 18-0072, S. 29 of the Connecticut Acts of the 2018 Regular Session, eff. 10/1/2018.

Amended by P.A. 17-0002, S. 138 of the Connecticut Acts of the 2017 Special Session, eff. 1/1/2018.

Amended by P.A. 16-0176, S. 1 of the Connecticut Acts of the 2016 Regular Session, eff. 6/6/2016.

Amended by P.A. 16-0012, S. 1 of the Connecticut Acts of the 2016 Regular Session, eff. 5/6/2016.

Amended by P.A. 15-0005, S. 370 of the Connecticut Acts of the 2015 Special Session, eff. 8/1/2015.

Amended by P.A. 15-0005, S. 358 of the Connecticut Acts of the 2015 Special Session, eff. 7/1/2015.

Amended by P.A. 15-0069, S. 17 of the Connecticut Acts of the 2015 Regular Session, eff. 6/19/2015.

Annotations to former section 17-134b: Cited. 168 Conn. 336 . Since disclaimer is invalid, state may reassess eligibility for assistance. 179 Conn. 463 . Cited. 199 C. 524 ; 204 Conn. 17 ; Id., 672; 216 Conn. 85 . Commissioner is obligated to provide medical assistance for any otherwise eligible person whose income is not more than minimum income permissible under federal law for such eligibility. 34 Conn.Supp. 525 . State regulation on Medicaid abortion funding is contrary to statutory provision. 40 Conn.Supp. 394 . Annotations to present section: Cited. 233 Conn. 557 . Medicaid law in effect at time of Medicaid application governs calculation of available assets even if different law was in effect at time trust was created or became irrevocable; widow's proceeds from trust created in 1968 were subject to spousal asset calculation under Medicare Catastrophic Coverage Act of 1988, disqualifying second husband from Medicaid eligibility. 312 Conn. 196 . Trust funds not available for purposes of determining Medicaid eligibility when trustee has absolute and sole discretion on whether and how to disburse funds for support of beneficiary and amount of trust would be quickly exhausted if trust were deemed available to cover cost of care. 321 C. 259 .