In cases using Old Age Assistance or Permanent or Total Disability (OAA or PTD) eligibility criteria, the maximum equity in cash or securities if no other available resources are owned is $999.99 for an individual prior to July 1, 2017. If married and living with spouse, the limit is $2,000 resources owned by either or both prior to July 1, 2017. The spousal maximum of $2,000 applies without regard to whether one member owns more than $1,000.
| Fiscal Year (FY) | MHABD Single Resource Limit | MHABD Couple Resource Limit | +/- Change |
|---|---|---|---|
| Current, through end of FY2017 | $999.99 | $2000.00 | |
| FY2018 | $2000 | $4000 | +$1000.01/$2000 |
| FY2019 | $3000 | $6000 | +1000/$2000 |
| FY2020 | $4000 | $8000 | +1000/$2000 |
| FY2021 | $5000 | $10000 | +1000/$2000 |
| FY2022 and each subsequent FY | +by COLA and rounded to the nearest 5 cents |
EXCEPTION: If one spouse entered a Medicaid certified bed on or after September 30, 1989 or received HCB Waiver Services January 1, 1993 or later, refer to Income Maintenance Manual section 1030.035.00 DIVISION OF ASSETS for determining resource eligibility.
When there has been DESERTION OR ABANDONMENT and the husband and wife are living apart, each person may own cash and securities up to the single individual maximum resource amount.
Section 208.010 RSMo outlines the value of cash and securities a claimant may own.
Cash and securities include:
NOTE: Do not exclude the amount of outstanding checks from the verified balance of accounts with financial institutions. In the Uniform Commercial Code, U.C.C. - Article 4 - Banks Deposits and Collections, outstanding checks are those checks that have been written by the account holder or authorized signatories but not yet settled with the financial institution.
Mortgages, Contracts for Deed, Deeds of Trust, promissory notes, and other sales contracts payable to the applicant/participant or their spouse may be an available resource. Refer to Income Maintenance Manual Sections 1040.015.10.05 Consideration of Certain Contracts, 1040.015.10.05.00 Promise to Pay, 1040.015.10.05.05 Promissory Notes, 1040.015.10.05.10 Property Agreements, and Section 1040.020.30 Determining Fair and Valuable Consideration.
Cash and securities may or may not be considered available resources to the applicant or participant. See the following manual sections for special circumstances. If cash and securities are not considered available see the FAMIS User Guide EXCLUDING MHABD RESOURCES.
Cash remaining from an assistance check or other budgeted monthly income received during the month of the eligibility determination is considered as income only. Do not consider it when determining the amount of cash and securities owned in that month.
If the applicant/participant has multiple accounts, verify into which account the monthly income is being deposited. Deduct the monthly income from this account. If the income is deposited into several different accounts, determine how much is deposited into each account, and deduct that amount from the appropriate account.
Income on a direct benefit card, such as the Child Support SecuritE card, would be considered as if it were deposited into a checking account. Any income remaining on the card the month following the receipt of the payment would be considered an available resource.
If income is received annually (such as sale of livestock in the fall) and put aside in a separate account for yearly maintenance, consider one-twelfth of the amount as income. The remainder is not considered as cash and securities for 12 months from date of the sale of livestock, etc. Any amount left over at the end of the 12 month period is considered cash and securities. If other funds are deposited in this account, such as a Social Security check; etc., consider the entire amount as cash and securities.
The money remaining from monthly income would be entered in FAMIS as Resource Class LR = Liquid Resources with Excl Rsn = CI CURRENT MONTH'S INCOME on the Liquid Resource (FMW0) screen.
Disregard 'relocation' payments received by an applicant/participant through the Uniform Relocation Assistance Act of 1970 when determining the amount of Available Resources or Cash and Securities. Section 216 of Public Law 91-646 states that payments to help a recipient resettle when property purchased by the State Highway Department or property purchased under the Housing Act causes an assistance recipient to relocate may not be considered in determining eligibility for public assistance.
EXAMPLE: The Missouri Department of Transportation purchases Mr. Jones' property for $12,500. In addition to the purchase price, they pay him $6,000 under the Uniform Relocation Assistance Act to help him relocate. Disregard the 'relocation' payment ($6,000) when determining eligibility.
When funds of the Uniform Relocation Assistance Act are received to supplement rent or because the applicant/participant's home has been purchased and the applicant/participant must move, the recipient may take the money in a lump sum for a contractual period of from one to four years. Determine from the contract the amount of payment received and the period of time it is intended to cover. This may need to be verified by the Relocation Authority Office. Exempt this amount from being counted as cash and securities and available resources only so long as it is maintained in a separate account and only for the length of the contractual period.
If at the end of the contractual period there is still money left in this account, consider it as cash and securities. These funds must be entered in FAMIS on the Liquid Resource (FMW0) screen with the MHABD Excl Rsn = UR UNIFORM RELOCATION ASSISTANCE.
EXAMPLE: An applicant/participant, who has been paying $50 per month rent, is relocated in living quarters costing $100 per month rent. The applicant/participant would be eligible for a lump sum relocation payment of $2400 to cover a contractual four year period. The applicant/participant has the option of getting the $2400in payments of $600 per year or a $2400 lump sum payment. In either situation, the money has to be deposited in a separate account or else must be considered as cash and securities.
NOTE: If the relocation funds are used to purchase property which is later sold within the contractual period, any money from the sale of that property immediately becomes a resource.
Payments made as a result of condemnation or eminent domain procedures are not included in the Uniform Relocation Assistance Act. These situations must be treated according to the policy covering Evaluation of Cash Received from Involuntary Conversion of Real Property into Personal Property.
RSMo 208.020. states: 'Any proceeds from involuntary conversion of real property into personal property (such as forced transfer under condemnation, eminent domain, and fire, flood, other act of God, or the like) received by a recipient while eligible to receive public assistance benefits under existing laws shall be exempt for a period of one year from the date of receipt of the proceeds. For the purposes of this section, the word 'receipt' means actual receipt of the proceeds or the payment into court of the proceeds, except that in condemnation cases where the initial exception to the commissioner's award is filed by the condemning authority, the word receipt means 'receipt' of an award under a final judgment.'
The proceeds would be entered in FAMIS as Resource Class LR Liquid Resources with MHABD Excl Rsn IC INVOLUNTARY CONVERSION OF REAL PROPERTY
Consider the following points when there has been an involuntary conversion of real property:
All trust documents are to be sent as an attachment with an Request for Interpretation of Policy (IM-14) form by email to FSD.IM14@dss.mo.gov to determine availability to the applicant or participant of the resources held in the trust. Include a copy of the entire original trust and any amendments. Also, include documentation of funding sources or assets used to establish the trust. If the trust is established by an insurance payment or other settlement, include documentation to show settlement proceeds flow through the trust.
As part of the annual review, eligibility specialists must review trusts, like any other assets, to determine if there has been a change in the trust that affects eligibility. Explore any amendments or changes that have occurred to the trust or in administration of the trust. If changes or amendments have occurred send the original trust documents and amendments or changes as an attachment with a Request for Interpretation of Policy (IM-14) form by email to FSD.IM14@dss.mo.gov to determine availability of the resources held in the trust.
Trusts may be established by:
A trust may be considered available to the individual for purposes of determining eligibility for MO HealthNet. How a trust is treated depends on:
Trust funds are added to FAMIS from the Select Financial Resource Screen (SELFRES, FMWB) as class LR Liquid Resource. Enter the trust on the Liquid Resource screen (FMW0) as Type TR TRUST/ANNUITIES. If it is an irrevocable trust, enter the MHABD Excl Rsn IT IRREVOCABLE CONTRACT/TRUST.
Special Needs Trusts (SNT) established under Section 1917(d) of the Social Security Act (42 U.S.C. 1396p(d)) are not counted as available resources to the individual provided the assets are held in the name of the trust. The assets of the individual may be used to establish the trust. Proceeds remaining upon the death of the individual will be claimed by MO HealthNet Division Estate Recovery, up to the amount expended for care for the individual. Proceeds remaining after distribution to MHD Estate Recovery will be distributed to residual beneficiaries in accordance with the terms of the Trust.
SNT include the following:
In the above instances, the trust must provide that the state of Missouri receives any funds remaining in the trust upon the death of the individual, up to the amount equal to the total amount of medical assistance paid on behalf of the individual through the MO HealthNet program.
Third Party Trusts are established with resources provided by someone other than the beneficiary of the trust or their spouse. "Tidrow" trusts and most "supplemental needs trusts" are third party trusts. The individual is the beneficiary, and a third party is often (but not always) the trustee. The trustee usually has discretion to distribute trust assets to the beneficiary, in accordance with guidance from the grantor. Upon the death of the beneficiary, a third party trust is not subject to MO HealthNet payback requirements. Proceeds remaining are distributed to residual beneficiaries in accordance with the terms of the trust.
NOTE: Grantors to third party trusts (the people who gave money to fund the trust) may retain the right to reclaim all or part of the contributions to the third party trust during their lifetime. When the grantor's contribution is revocable, the amount of the contribution remaining in the trust is an available resource to the grantor if he/she is an applicant or participant.
EXAMPLE: Mr. S has a disabled grandchild. Mr. S contributes $85,000 to establish a trust account to supplement the care of his grandchild. Mr. S made his contribution revocable. Later, Mr. S later applies for MO HealthNet. The eligibility specialist must determine the amount in the grandchild's trust account available to Mr. S., to be counted as an available resource.
NOTE: Parents can give money to a blind or disabled child (this does not include step-children) without restrictions on the age of the child and this is not considered a transfer of property.
Related and unrelated individuals may transfer assets to a trust established for the sole benefit of a disabled individual under age 65 and this is not considered a transfer of property. See Section 1040.000.00 TRANSFERS OF PROPERTY.
Chapter 402 of the Revised Statutes of Missouri authorized the Missouri Family Trust Fund to provide benefits that supplement public assistance for persons with a mental or physical impairment that substantially limits one or more major life activities, whether the impairment is congenital or acquired by accident, injury or disease; and where the impairment is verified by medical findings. The Missouri Family Trust, now doing business as Midwest Special Needs Trust, is a 501(c)(3) non-profit agency established by legislation (402.199 RSMo). Trusts established by Midwest Special Needs are pooled special needs trust as described in Section 42 U.S.C. 1396p(d)(4)(C).
The Midwest Special Needs Trust (MSNT) provides a method for relatives and other individuals or entities to contribute to the supplemental care of disabled persons. Cash and other liquid assets in the form of stocks or bonds, money market funds and treasury bills may be contributed to the trust. Also, receipts from insurance policies, annuities, or settlements may be used.
The money in an msnt account is not considered as an available resource for the beneficiary. Distributions made to meet living and health care needs, to supplement, but not replace, the basic support provided by state government and other governmental programs, is not considered as income to the beneficiary.
Trusts with MSNT are administered as one trust fund; however, separate accounts are established for each individual. Two types of trusts are available.
NOTE: Funds transferred to a first party MSNT for an individual age 65 and over are subject to a transfer penalty upon admittance to a long term care facility.
All trust documents are to be sent as an attachment with a Request for Interpretation of Policy (IM-14) form by email to FSD.IM14@dss.mo.gov to determine availability to the applicant or participant of the resources held in the trust.
Under 42 USC 1396p(d)(4)(B), the state of Missouri will exclude earned or unearned income of a participant in a Qualified Income Trust (QIT) program and any income derived from these deposits in determining the assets of a participant. This exclusion applies only to the QIT participant. The QIT programs are:
NOTE: if the QIT participant enters a nursing home or similar institution and becomes eligible for MO HealthNet pursuant to 208.151.1(7) RSMo, the amount of income deposited into the trust account shall be considered in determining any post-eligibility contribution (surplus) the participant is responsible to pay under 42 C.F.R 435.733.
NOTE: Income that is deposited into a qualifying income trust may be reallocated to a community spouse pursuant only to a hearing under 42 USC 1396r-5(e)(2).
All trust documents, regardless of type of trust, are to be sent as an attachment with a Request for Interpretation of Policy (IM-14) form by email to FSD.IM14@dss.mo.gov to determine availability to the applicant or participant of the resources held in the trust.
Consider the total amount on deposit in a joint bank account, of which the applicant/participant is one of the owners, as available unless there is verification the money placed in the account or a definite portion of it belongs to the other joint owner(s).
EXCEPTION: If the applicant/participant is married and living with spouse, consider the total amount on deposit, whether owned individually or jointly with the spouse, as available to the applicant/participant.
When both or all of the owners of a joint bank account, who are not married to each other, are applying for or receiving assistance, each is considered as owning their proportionate share of the account.
Once it is verified a joint bank account exists of which the applicant/participant is one of the owners, the total amount on deposit is not considered as a resource if the applicant/participant states he or she has not deposited any portion of the money in the account and past circumstances and/or bank records indicate this is reasonable. Only the portion of the joint account determined to belong to the applicant/participant is counted as a resource.
Some factors to consider in accepting the applicant/participant's statement are employment, health, or assistance history which indicates the applicant/participant had little or no opportunity to acquire such assets.
Accounts listed in the name of a Corporation, S Corporation, or Limited Liability Corporation may be excluded as an available resource as long as the applicant or participant is listed as an owner of and actively engaged in the business. For business accounts, if the applicant/participant can provide documentation proving the only deposits and withdrawals are for business purposes, the account can be excluded as an available resource. If there are deposits from any other source of income, such as SSA, child support, wages from other sources, or the funds in the business account are used for personal expenses of the applicant /participant, then they are considered an available resource.
For disabled children (under age 18) exclude retirement accounts (individual retirement accounts (IRA), 401(k) plans, 403(b) plans, Keogh plans, pension plans, etc.) that belong to the parents of the disabled child.
NOTE: Retirement accounts belonging to all other MHABD applicants/participants and/or their spouses, except those belonging to former MA-WD recipients are considered as an available resource. (Refer to Section 1025.015.09)
Settlement payments made from the Ricky Ray Hemophilia Relief Fund, or paid as a result of a class action settlement in the case of Susan Walker v. Bayer Corporation are not to be considered resources. Enter on the Liquid Resources (FMW0) screen in FAMIS with MHABD Excl Rsn RR RICKY RAY HEMOPHILIA FUND. Any money derived from the investment of these funds may be considered income. Thus, if the payments are placed in an interest-bearing account, or some other investment medium producing income, the income generated by the account may be counted as income to the individual.
Individuals receiving settlement payments, who dispose of part or all of awarded monies in a manner that normally would be considered a transfer of property, are excluded from any transfer penalties related to these funds. Similarly, settlement payments placed in trusts, which would normally be governed by the trust provisions, are also excluded. However, any income derived from the trust may be considered income to the individual.
Retirement accounts funded by earnings received while an individual was a recipient of MA-WD (Sections 0855.000.00 through 0855.025.00) are excluded as a resource for all MO HealthNet categories. The exclusion also applies to MO HealthNet applications for the individual's spouse and/or child, until the individual turns age 65. Retirement accounts include individual accounts, 401(k) plans, 403(b) plans, Keogh plans, or pension plans, and the earnings on those accounts.
Example: Mr. Jones, age 54, received MO HealthNet under the MA-WD program for 24 months. During his time on MA-WD, he contributed $2,000 to a 401(k) plan. Later, Mr. Jones is no longer working. He applies for MO HealthNet under the MHABD PTD program. Mr. Jones' 401(k) plan is now worth $2,100, which includes the initial $2,000 contributed while employed, and $100 in interest earnings. Exclude the total amount of $2,100 from his available resources. When Mr. Jones turns 65, include the entire amount in the 401(k) plan as an available resource.
Exclude health savings accounts and independent living accounts from resource consideration when:
EXAMPLE: Mr. Thompkins is approved for MHABD on 9/1/17. From 9/1/17 to 12/31/17 he deposits $5,000 from earnings he received while on MHABD into a medical savings account and another $5,000 in earnings into an independent living account. In 2018 Mr. Thompkins deposits another $5,000 from his earnings into both his medical savings account and his independent living account bringing the account balance to $10,000 for each account. Mr. Thompkins remains eligible for MHABD coverage as his deposits into the medical savings account and independent living account did not exceed $5,000 during any one year period while he has been receiving MHABD.
Exclude income and resources from an SSI Plan for Achieving Self-Support (PASS) for MHABD, SNC, and SAB. Blind or disabled SSI recipients may have a plan in writing and approved by the Social Security Administration to set aside money for a certain amount of time for a work goal to help them achieve self-support. Income and resources that are set aside under an approved PASS are excluded from countable income and resources for as long as the plan is in effect for blind or disabled SSI recipients. The claimant receives an approval letter from SSA when a plan is approved. A copy of this letter or other documentation from the Social Security Administration must be obtained to verify the resource has been designated as an approved PASS account, and the length of time the account is excluded.
A plan can be approved initially for up to 18 months, may be extended, but can never exceed 48 months. The plan can be amended with approval from SSA. SSA must periodically review plans to assure compliance.
PASS accounts are entered in FAMIS on the Liquid Resource (FMW0) screen as Type PA PLAN FOR ACHIEVING SELF-SUPPORT (PASS) MONIES and MHABD Excl Rsn IL INDEPENDENT LIVING ACCOUNT
The last effective month for a PASS is the earliest month in which one of the following events occurs:
The PASS account is no longer excluded the month after the last effective month for a PASS.
The Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA) established a new requirement for handling some payments of past due amounts to Supplemental Security Income (SSI) recipients under age 18 who have representative payees.
If a past due payment is a payment of monthly benefits greater than six times the current SSI maximum for one person, then the representative payee must deposit the payment into a dedicated account. The requirement applies to all such payments made after August 22, 1996. The Social Security Administration (SSA) will not pay past due monthly benefits until a dedicated account has been established. SSA will direct deposit these payments into the dedicated account.
A dedicated account for an SSI recipient may be a:
A dedicated account for an SSI recipient may not be a:
The title of the account must show that the child owns the funds (including interest), but only the payee can access the funds on the child's behalf. The account must have the sole purpose of receiving and maintaining SSI past due benefits. Other payments (regular SSI payments, OASDI payments, and other income) may not be deposited into the dedicated account. Interest earned by the account may be deposited into the account.
Once a dedicated account is established, other past due amounts that exceed six times the SSI maximum for one person must be deposited into it. Past due amounts which are at least equal to the SSI maximum for one person and are less than or equal to six times the SSI maximum for one person may be deposited into the account, but is not a requirement.
The dedicated account is to be used only for the benefit of the child and only for certain expenses:
Any funds in an SSI dedicated account are not considered an available resource for all MO HealthNet programs. The exclusion of a dedicated account continues until the account is depleted or eligibility for SSI terminates, whichever comes first. If SSI eligibility ends, any balance remaining in the dedicated account must be considered an available resource to the former SSI recipient.
The exclusion continues to apply in any of the following situations:
SSI dedicated accounts are entered in FAMIS on the Liquid Resource (FMW0) screen as Type DE DEDICATED ACCOUNTS and MHABD Excl Rsn GP GOVERNMENT PAYMENT (SSI/TRIBE PAYMENTS, ETC.)
A custodial account is an account for the benefit of a minor child and managed by a parent or another designated custodian. The custodial account is established under Sections 404.005 to 404.094 Revised Statutes of Missouri, the Missouri Transfers to Minors Law. The custodian normally controls the account until the child attains the age of 21. Accounts established under the Missouri Transfers to Minors Law are not considered as an available resource until the child is 21 years of age.
If the minor is an incapacitated person at the time the minor would otherwise be entitled to receive the custodial property free of the custodianship, the custodian shall deliver the custodial property to the incapacitated person's conservator. If the incapacitated person has no conservator, the custodian may transfer the custodial property to any adult person or financial institution, including the custodian, as personal custodian for the incapacitated person under any law providing for custodianship of property for incapacitated adult persons.
Proceeds from a loan are anything an individual or their spouse receives from someone that they agree to pay for at a later date. The applicant/participant or their spouse can make the agreement with a lending institution such as a bank, or another individual. The loan agreement must be enforceable under State law.
A loan is bona fide if:
If the loan is bona fide, the value of the cash or item the applicant/participant or their spouse receives is not income. However, any borrowed funds not spent in the month received, will count as an available resource the next month.
Reverse mortgages are considered a type of bona fide loan and are not considered as income or a resource for the month the payment is received. Payments from a reverse mortgage may be received in a lump sum or in monthly payments. If any funds remain from the reverse mortgage payment in the month following the month of receipt, the remaining funds are considered as an available resource.
Payments made from the Agent Orange Settlement Fund or any other fund established pursuant to the settlement in the In Re: Agent Orange product liability litigation, M.D.L. No. 381 (E.D.N.Y.) shall not be considered income or resources in determining eligibility for or the amount of benefits under any state or state-assisted program.
MHABD vendor participants may have Medicare covered days when they enter a facility. Medicare may pay for all or part of the skilled nursing facility (SNF) covered services for the first 100 days of care if the resident is in a Medicare certified facility and meets certain other requirements. For any month in which part or all of the charge for every day is covered by Medicare, the participant will not have to pay their surplus amount to the nursing facility. Eligibility Specialists (ES) are not responsible for tracking Medicare covered days. However, ES must be aware that a vendor recipient who goes to a Medicare certified facility may not always be required to pay their surplus amount especially during the first part of their stay. A resident who is not paying the surplus amount may acquire resources which could exceed the limit of $999.99. In that event, when information is entered in FAMIS to show available resources exceed the maximum, the ES should authorize the adverse action closing. When an active MHABD participant has available resources that cause ineligibility, the client can choose to pay the MO HealthNet Division Third Party Liability Estate Recovery Unit to retain their eligibility. The participant or their representative would need to contact the MHD TPL unit to make the arrangements.
The Tax Increase Prevention Act of 2014, Public Law No: 113-295.
Achieving a Better Life Experience (ABLE) accounts are tax-advantaged accounts that eligible individuals can use to save funds for qualified disability expenses (QDEs). These accounts are administered by the State Treasurer and are also known as STABLE accounts or MOABLE accounts. Funds in ABLE accounts are excluded in resource determinations for all federally funded, means tested programs. An individual is limited to one ABLE account. The following income types are excluded to the owner/beneficiary of an ABLE account:
Note: Medical expenses paid with funds from an ABLE account cannot be used to meet spend down.
Example: Amy’s mother deposits $100 into Amy’s ABLE account. The amount her mother deposits is not counted as part of Amy’s income.
Note: Third party contributions to an ABLE account may need to be assessed for a transfer of property if the contributor is covered by or seeks eligibility for MO HealthNet benefits.
Income deposited into an ABLE account by the owner/beneficiary is NOT excluded from the participant’s income.
Example: John receives $500 a month from a part-time job. He deposits $50 of his earnings into his own ABLE account. Despite his deposit, his entire wage amount of $500 per month counts in his income determination.
For more information regarding ABLE accounts, visit https://www.moable.com/.