For medical backdating months, verify the amount of liquid resources available on the first day of the month before income is added or expenses paid out of the person's account(s). Any net income added to an account after the first of the month remains income until the end of the calendar month. Add the amount of available liquid resources to the value of available non-liquid resources to determine the amount of total available resources for the month.
Liquid resources include bank accounts, credit union accounts, investment accounts, and other accounts in which the person keeps resources that can be readily converted to cash.
- Example: Ms. H requests backdating for September and provides proof that she had $3,200 in her bank account on September 10th. The bank provides statements from the 10th of one month through the 9th of the following month. The caseworker requests the statement beginning with August 10th and ending September 9th. Based on this statement, Ms. H had $2,800 in the account on September 1st before her monthly Social Security was deposited or any expenses were paid from the account. The caseworker uses $2,800 as available resources in the account for the backdate month of September.
Deny coverage for a requested backdate month if the customer fails to provide proof of resources for that month but approve regular coverage and coverage for other requested backdate months if required information is provided and eligibility is confirmed. Do not deny the entire application if the customer fails to verify resources that only apply to a backdate month. If the customer later provides the resource (or income) verification that applies to a denied backdate month, the additional month must be added through the Exception Processing Unit (EPU). If the customer has an income/resource spenddown for the affected month(s), he or she must also provide proof of medical expenses for eligibility to be added.
- Example: Mr. P requests medical backdating but has excess resources of $2,400 for April, $2,100 for May and $1,800 for June. He also has a $140 monthly income spenddown. Mr. P provides proof of $2,500 in allowable medical expenses from February and March (WAG 15-08-05; PM 15-08-06). He meets spenddown for May and June ($2,100 resource spenddown + $140 income spenddown for May; $140 income spenddown for June). Apply the additional $120 as carryover for a future month.
To receive coverage for all 3 months, Mr. P must provide proof of $2,820 in medical expenses ($2,400 resource spenddown + $140 income spenddown for each of the 3 months).