MA FOR PEOPLE WHO ARE AGE 65 OR OLDER AND PEOPLE WHO ARE BLIND OR HAVE A DISABILITY

2.3.3.2.1.1 Reasonable Compatibility Check for Assets

At application or when a person returns a renewal form, the agency conducts a reasonable compatibility check to determine asset eligibility for an applicant or enrollee. Reasonable compatibility is checked by comparing the value of total reported countable assets and the value of total verified countable assets to the program asset limit. If these values are both at or below the program asset limit, assets are considered verified, and the person is asset eligible.

Workers must assist applicants and enrollees who are unable to provide paper proof, including obtaining their authorization to contact a third party on their behalf, if appropriate. Self-attestation is accepted if electronic verification or paper proof do not exist or are unavailable.

Reasonable Compatibility Check

Reasonable compatibility is checked by comparing the applicable program asset limit to reported assets and verified assets.

Reported Assets

The total value of assets that an applicant or enrollee reports which includes:

  • Assets reported on the application or renewal.
  • At renewal, assets recorded in the case file.

Verified Assets

The value of total verified countable assets.

This includes:

  • Financial accounts, if any, returned by AVS or other reliable electronic sources.
  • Any financial accounts reported on the application or renewal (including at renewal, accounts known to the agency) that do not appear in the AVS results.
  • All other verified assets

When an applicant or enrollee sends paper proof with the application or renewal the most recent proof must be used. If AVS returns results for a financial account and the person provides more recent paper proof for the same financial account, the paper proof must be used.

Both the value of total reported countable assets and the value of total verified countable assets must be at or below the program asset limit for the applicant or enrollee to be asset eligible.

When determining eligibility for Medicare Savings Programs (MSP) and Medical Assistance (MA), MSP must be approved or renewed without requiring the person to provide further verification of assets for that program if assets are reasonably compatible for MSP but are not reasonably compatible for MA.

Example

A person applies for MA for persons who are age 65 or older, which has an asset limit of $3,000. On the application form, bank account #456 is reported with a balance of $850. Two vehicles are reported. One is excluded and the other one is counted. The counted vehicle has a value of $1,000. AVS results show one bank account #456 with a balance of $950.

Reported assets: The total value of the reported assets is $1,850 (the checking account of $850 plus the counted vehicle valued at $1,000), which is below the MA program asset limit of $3,000.

Verified assets: The total value of the assets returned from AVS is $950 on the same account that was reported. Adding the verified value of $1,000 for the counted vehicle, the total value of verified assets is $1,950, which is below the MA program asset limit of $3,000.

The value of the total countable assets is reasonably compatible because the reported and verified results are both at or below the MA program asset limit.

Not Reasonably Compatible

Assets are not reasonably compatible when one or both of the values in the reasonable compatibility check are over the applicant or enrollee’s program asset limit.

When AVS values of financial accounts are used in the reasonable compatibility check and assets are not reasonably compatible, more information must be gathered from the applicant or enrollee about the assets before determining eligibility. Eligibility must not be denied or closed until the applicant or enrollee has had an opportunity to provide verification of the current value of assets or verify that assets have been reduced.

An applicant or enrollee who does not provide the requested information by the due date is not eligible. Eligibility for the applicant or enrollee must be denied or closed with 10-day advance notice to the enrollee.

Example

A person applies for MA for persons who have a disability, which has an asset limit of $3000. On the application form, bank account #123 is reported with a balance of $900. Two vehicles were reported. One is excluded and the other one is counted. The counted vehicle has a value of $1,200. AVS results show a checking account #123 with $1,300 and a savings account #789 with a balance of $1,000.

Reported assets: The total value of the reported assets is $2,100 (the checking account of $900 plus the counted vehicle valued at $1,200), which is below the MA program asset limit of $3,000.

Verified assets: The total value of the assets returned from AVS is $2,300. Adding the verified value of $1,000 for the counted vehicle, the total value of verified assets is $3,300, which is above the MA program asset limit of $3,000.

The assets are not reasonably compatible because the verified assets value is above the MA asset limit. See EPM 2.3.3.6 MA-ABD Excess Assets for information on how a person can reduce their assets.

 

Legal Citations

Section 1940 of the Social Security Act

42 Code of Federal Regulations, § 435.916

42 Code of Federal Regulations, § 435.952

Minnesota Statutes, section 256.01, subdivision 18f

Minnesota Rules, part 9505.0095