12/22/2023
Summary:
- The resource test was suspended in 03/2020 due to the public health emergency (PHE). As of 05/12/2023 the resource test was resumed.
- Effective 05/12/2023, the AABD medical resource limit has been increased to $17,500 for non-MAGI programs. The $17, 500 limit applies to each household, no matter the number of persons in the household.
- The resource test resumption applies to all new applications and redeterminations processed on or after 05/12/2023.
NOTE: The resource limits have not changed for HBWD and AABD cash programs.
Please see table below for medical program resource limits.
| Medicaid Program |
Resource Limit 1 Person |
Resource Limit 2 People or More |
| AABD |
$17,500 |
$17,500 |
| MSP |
$9,090 |
$15,160 |
| HBWD |
$25,000 |
$25,000 |
Verifying Resources
Resources must be verified and entered in IES in the appropriate Resource screens.
Please refer to PM 07-02-00: Aid to the Aged, Blind, and Disabled for more information on exempt and nonexempt resources.
REMINDER: For AABD medical backdated months, the verified amount of countable resources available on the first day of each individual month must be used to determine eligibility for each month in the backdated request. Each month is determined separately as a standalone month. Review the Adding Resources for AABD Prior Month Requests wizard for further details on adding resources for backdated months.
Review of Resources at Redetermination
Verify and enter current resources in IES on the appropriate Resource screens. Please refer to PM 07-02-00: Aid to the Aged, Blind, and Disabled for more information on exempt and nonexempt resources.
Enter resource records to reflect the current resources received. Send a VCL if additional information is required to verify resources.
Cases that were approved prior to 04/01/2023 with a community spouse will not have the community spouse resource allowance (CSRA) reviewed at redetermination.
Asset Verification System (AVS)
Revisions have been made to integrate AVS in the REDE process and new application processing.
Refer to MR #23.17: Integration of the Asset Verification System (AVS) and MR #19.09 Asset Verification System for more guidance on issuing a VCL for resources.
Penalty Periods
Non-allowable transfers need to be reviewed as part of the long term care look back period for individuals receiving long term care services. This includes individuals living in supportive living facilities (SLF), skilled nursing facilities (SNF) and those receiving Department on Aging (DoA) services. Review transfers for new applications, redeterminations and when determining eligibility for long term care services.
- If a non-allowable transfer is found prior to the long term care admission being completed, the beginning date of the penalty period is the later of:
- the date the person becomes otherwise eligible for SNF, SLF, or DoA HCBS waiver services (including meeting any spenddown and following any days fully covered by Medicare); or
- the first day of the month during which the transfer for less than fair market value is made; or
- the first month that can be affected for an ongoing case allowing for timely notice to be sent to the individual.
- If a non-allowable transfer is found after the long term care admission has already been completed, only the remaining portion of the penalty period can be applied.
- The penalty period begin date is adjusted to the first day of the month following the month of decision for cases that have been approved for LTC services when:
- The case doesn't have LTC NH/SLP SPD EDG; and
- The end month of the penalty period calculated by IES is after the month of decision.
Disregard penalty months that end prior to the month of decision for cases that have been approved for LTC services. Only penalty months that continue past the month of decision will be imposed. The begin date of any remaining penalty period months is the first day of the month following the month of decision.
Refer to PM 07-02-20-d: Penalty Period Due to Non-Allowable Transfers for more information.
NOTE: Contact the BMESP if the case should have a resource reduction and a penalty period after the admission has been completed.
LTC-Asset Discovery Investigation (ADI) Referrals
Continue to follow the same referral criteria for LTC-ADI. The LTC offices and FCRC are required to refer applications and redeterminations to LTC-ADI that meet the referral criteria.
If a case meets criteria to be sent to OIG during the redetermination process:
- The caseworker should first complete the REDE based on the income, resources and other required information and certify the case; and
- Return to case in case change action and complete the OIG referral.
Manual Revisions:
[signed copy on file]
Dulce M. Quintero
Secretary-Designate, Illinois Department of Human Services
Theresa Eagleson
Director, Healthcare and Family Services
