1030.000.00 Available Resource (OAA and PTD)

1030.055.05 How to Apply the Asset Disregard

IM-148 December 22, 2022

Disregard assets or resources equal to the amount of long-term care benefits paid on behalf of a participant by a qualified long-term care partnership policy. Staff must verify with the long-term care insurance company the amount of benefits paid to or on behalf of the applicant as of the month of application.

The insurance benefits upon which a disregard may be based include benefits paid:

  • as a direct reimbursement of long-term care expenses paid while the participant was residing in a nursing facility or at home; or
  • on a per diem, or other periodic basis, for periods during which the individual received long-term care services.

The asset disregard is applied to resources considered available to the participant as defined in section 1030.000.00 Available Resource (OAA and PTD) of this manual.

NOTE: The benefits available under a qualified long-term care policy are not required to be fully exhausted before the disregard of assets is applied.

EXAMPLE: Mr. Manning applied for Mo HealthNet vendor benefits on August 6. He owns a $75,000 home in Missouri where he lived prior to entering the nursing facility. He also has a certificate of deposit (CD) at the local bank for $50,000. Mr. Manning has a qualified long-term care partnership policy that he purchased in Indiana eight years prior to his application for benefits in Missouri. Staff contacted the long-term care insurance company and verified that the amount paid on behalf of Mr. Manning for long-term care benefits as of August was $65,000.00. Missouri Department of Commerce and Insurance (DCI) verified the policy qualifies as a long-term care partnership policy.

When determining Mr. Manning’s eligibility for vendor care, the asset disregard is applied to Mr. Manning’s $50,000 CD. The home is already exempt as an asset in determining eligibility. Therefore, Mr. Manning is eligible for vendor benefits in Missouri, if all other eligibility requirements are met.

A TPL-1 form for the long-term care policy is completed and sent to MO HealthNet Division’s Third Party Liability Unit along with an attachment verifying he qualifies for $65,000 asset disregard during estate recovery.

EXAMPLE: Ms. Dallas applied for MO HealthNet vendor benefits in Missouri on August 6. Ms. Dallas owns a $50,000 home in Missouri where she lived prior to entering the nursing facility. She has no other assets. Ms. Dallas purchased a qualified long-term care partnership policy in California six years ago. The eligibility specialist verified that the amount paid for long-term care benefits on her behalf as of August was $25,000. DCI verified the policy qualifies as a long-term care partnership policy.

When determining Ms. Dallas’ eligibility for vendor care, it is determined the home is already exempt. Ms. Dallas is eligible for vendor benefits in Missouri, if all other eligibility requirements are met.

A TPL-1 form for the long-term care policy is completed and sent to MO HealthNet Division’s Third Party Liability Unit along with an attachment verifying she qualifies for $25,000 asset disregard during estate recovery.

NOTE: Because Ms. Dallas qualifies for MHABD without applying the asset disregard to determine eligibility, staff are not required to hold the application in pending status to verify the amount of disregard to apply during estate recovery. The application can be approved without the verification of the disregard to apply during estate recovery. If the application is approved without verification, a TPL-1 form must be completed for the long-term care policy and sent to MO HealthNet Division’s Third Party Liability Unit along with an attachment alerting them about the possibility of eligibility for an asset disregard during estate recovery.