December 1973 Eligibility Requirements

1030.055.05 How to Apply the Asset Disregard

Disregard assets or resources equal to the amount of long-term care benefits paid on behalf of an individual from the eligibility determination if the long-term care policy meets the requirements of a qualified long-term care partnership policy. DIFP will certify which long-term care policies qualify as long-term care partnership policies. The total amount of assets disregarded is the total amount of long-term care benefits paid to or on behalf of the individual as of the month of his or her application for MO HealthNet for the Aged, Blind, and Disabled (MHABD) benefits. The asset disregard is applied to resources considered available to the participant as defined in Income Maintenance Manual Sections 1030.000.00–1030.030.10.15 .The eligibility specialist 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 amount disregarded as an asset in determining eligibility and in estate recovery is the amount the insurance carrier verifies as paid to or on behalf of the individual as of the month of application. Submit any questions regarding the amount of asset disregard for a qualified long-term care partnership policy on an IM-14 Request for Policy Interpretation to the IM Program and Policy Unit through regular supervisory channels.

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 moved to Missouri from Indiana in 2005. He applied for Mo HealthNet vendor benefits in Missouri on August 6, 2008. Mr. Manning 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. The eligibility specialist 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 2008 was $65,000.00. DIFP verified the policy qualifies as a long-term care partnership policy.

When determining Mr. Manning’s eligibility for vendor care, the eligibility specialist disregards $65,000 of his assets. The eligibility specialist applies the asset disregard 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.

The eligibility specialist completes a TPL-1 form for the long-term care policy and sends it 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 moved to Missouri from California in 2006. She applied for MO HealthNet vendor benefits in Missouri on August 6, 2008. 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 2008 was $25,000. DIFP verified the policy qualifies as a long-term care partnership policy.

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

The eligibility specialist completes a TPL-1 form for the long-term care policy and sends it 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, the eligibility specialist is 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, the eligibility specialist must complete a TPL-1 form for the long-term care policy and send it 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.