Case Law Library

When purchasing a Medicaid Compliant Annuity (MCA), the policyholder has the right to a 30-day freelook period. However, in some cases, the policyholder can waive that cancellation period allowing the contract to become immediately irrevocable. In this case, despite the Petitioner completing the proper forms to waive the freelook period, the Department included the MCA as an available resource during that period. As such, Petitioner was not eligible for Medicaid benefits until the month after the policy's freelook period had expired. Petitioner appealed.

Following the Petitioner's admittance to a nursing home, the community spouse purchased an annuity with a portion of the couple's excess resources. The couple applied for Medicaid and the county completed a resource assessment where it was determined that the community spouse's purchase of the annuity constituted an improper transfer of assets. As such, the institutionalized spouse was assessed a period of ineligibility. The couple appealed the department's determination to the state trial court.

In this case, a question of whether Minnesota's Medicaid plan conflicted with federal law was raised when Minnesota's eligibility requirements stated that a penalty period could no longer be shortened by a partial return of assets.

The Georgia Department of Community Health (DCH) imposed an asset transfer penalty on four different Medicaid applicants because either they or their spouse did not name the state as the appropriate remainder beneficiary of the annuity. The court held that the annuity purchased by the institutionalized individual was protected from a penalty. However, the annuities purchased by the community spouses were subject to the penalty and were required to list the state as the appropriate beneficiary.

In this case, the payments made to the Petitioner's son under the terms of the Personal Services Agreement (PSA) were examined after the Petitioner failed to provide a sufficient summary of the care services that were provided by the son. As such, DHS determined that the payments made to Petitioner's son were uncompensated transfers and assessed him a 13-month period of ineligibility. Petitioner appealed the Department's decision.

Prior to submitting an application for Medicaid benefits, the community spouse purchased a non-assignable promissory note with a portion of the couple's excess countable resources. Upon review of the couple's Medicaid application, the Department imposed a period of restricted coverage of the institutionalized spouse's benefits after determining the purchase of the promissory note was an improper transfer. At issue was whether the purchase of a promissory note by the community spouse which meets Ohio Administrative Code requirements, should be excluded from the couple's countable assets.

Following the institutionalized spouse's admittance to an Arkansas nursing facility, the couple applied for Medicaid benefits. The Department determined that the couple had resources that exceeded the eligibility limits and denied the application. As a result, the couple purchased two Medicaid Compliant Annuities and submitted a new application. The second application was denied and the Department assessed the institutionalized spouse a period of ineligibility based on the purchase of the annuities. The court was asked to determine if the Department erred in their determination to include the annuities as a countable resource.

As part of their Medicaid spend-down, the community spouse purchased a Medicaid Compliant Annuity. Shortly after purchasing the annuity, the community spouse passed away. As the primary beneficiary, AHCCCS continued to pay for the institutionalized spouse's care and recoup the costs from the continuation of the annuity payments. Following the institutionalized spouse's removal from the nursing home, the contingent beneficiary sued AHCCCS stating that they were not entitled to recover any benefits from the annuity and were certainly not authorized to recover funds from the annuity for benefits paid after the community spouse's death.

A section of Georgia's Medicaid manual was examined in this case to determine whether the state's regulations regarding transfer of resource penalties directly conflicted with federal law. Petitioner purchased a single premium immediate annuity and named her children as the beneficiaries. However, the state of Georgia required that she name the state. When she refused, the agency assessed her a transfer of resource penalty for the purchase price of the annuity. The Petitioner appealed.

Prior to applying for Medicaid, the couple sold their rental house to their son using a promissory note. The state Medicaid agency included the promissory note as a countable resource. As a result, the institutionalized spouse was denied benefits. The couple appealed and the court was asked to determine whether a promissory note that cannot be converted to cash is a "resource" for Medicaid eligibility purposes.