Verification Requirements for Medicaid/MC+ and Cash Assistance Programs

0110.040.15 Life Insurance and Pre-need Burial Plans

IM#144 November 22, 2017, IM#19 March 19, 2015, IM-34, April 4, 1998

  1. a. Life Insurance: The IM-9 form may be used to obtain verification of the cash surrender value (CSV) of life insurance from the company, if the applicant/participant indicates s/he does not have and cannot obtain the necessary verification. The table of values in a policy is not sufficient to establish value.

    NOTE: If the insurance company will not provide the information requested to the FSD, requires payment for the response, or requires a company specific form, inform the applicant/participant that they must obtain the information from the institution directly.

  2. Pre-need Burial Plans: Obtain a copy of the contract, the amount paid on the contract and election of irrevocability from the funeral home.
  3. Life insurance irrevocably assigned to fund a pre-need burial contract: Obtain verification from the funeral home that there is a valid pre-need burial contract (between the funeral home and the claimant) funded by the irrevocable assignment of the claimant’s life insurance policy. Use the date the claimant signs the documents to fund a pre-need burial with life insurance as the date CSV is unavailable.