PM 07-02-23-b

Example 1: Mr. A purchased a Partnership policy with a maximum benefit payout of $50,000. At the date of purchase, the policy did not provide coverage equal to, or greater than, the average cost of 4 years of long term care services in a nursing facility. He enters a nursing facility and the insurance policy pays benefits. When the policy has paid all benefits that are payable, he applies for Medicaid. Mr. A provides verification from the insurance company that all benefit payments ($50,000) have been made.

Disregard the asset protection amount of $50,000 when completing an initial determination/REDE of Medicaid eligibility. This amount is in addition to any exempt assets or other disregarded amounts.

Example 2: Ms. B has a Partnership policy. At the date of purchase, coverage is equal to, or greater than, the average cost of 4 years of long term care services in a nursing facility. She enters a nursing facility and the insurance policy pays benefits. When the policy has paid all benefits that are payable, she applies for Medicaid.

Ms. B provides verification from the insurance company that all benefit payments have been made.

Disregard all assets when completing an initial determination/REDE of Medicaid eligibility.