Until automated notices are available the following text and citations should be printed on the manual Advance Notice sent to the person in the LTC facility as well as all involved parties, informing them that the person is no longer eligible for payment of LTC facility services:
Because you gave away or transferred a total of $ _____ in assets for
less than fair market value you no longer qualify for payment of services in a
Long-Term Care (LTC) facility beginning on ____ and ending on _____.
During this time period, you will need to pay the LTC facility for the LTC
services you receive. If you believe that the denial of the payment of LTC
services will deprive you of medical care, food, clothing, shelter or other
necessities of life which would endanger your health or life you may ask for
an undue hardship waiver.
42 U.S.C. § 1396p(c); 62 P.S. § 441.5 and 55 Pa. Code §§ 178.104, 178.104a,
178.104b
Until automated notices are available the following text and citations should be printed on the manual Advance Notice sent to the person receiving HCBS as well as all involved parties, informing them that the person is no longer eligible for payment of HCBS:
Because you gave away or transferred a total of $_____ in assets for less than fair market value you no longer qualify for payment of Home and Community Based Services (HCBS) beginning on _____ and ending on _____. During this time period, you will need to pay the service provider for the HCBS you receive. If you believe that the denial of the payment of HCBS will deprive you of medical care, food, clothing, shelter or other necessities of life which would endanger your health or life you may ask for an undue hardship waiver.
42 U.S.C § 1396p(c); 62 P.S. §§ 441.5, 441.8 and 55 Pa. Code §§ 178.104 178.104a, 178.104b
ELIGIBLE FOR MA BUT NO LONGER ELIGIBLE FOR LTC NOTICE TEXT-EXCESS HOME EQUITY
Until automated notices are available the following text and citations should be printed on the manual Advance Notice sent to the person residing in a LTC facility as well as all involved parties, informing them that the person is no longer eligible for payment of LTC facility services:
Because the equity value of your home is $____ which exceeds the home
equity limit of $____ you no longer qualify for payment of services in a
Long-Term Care (LTC) facility beginning on _____.
Beginning on this date, you will need to pay the LTC facility for the LTC
services you receive. As long as the equity value of your resident property
exceeds $____ you will not qualify for payment of LTC services. If you
believe that the denial of the payment of LTC services will deprive you of
medical care, food, clothing, shelter or other necessities of life which would
endanger your health or life you may ask for an undue hardship waiver.
42 U.S.C. § 1396p(f) and 55 Pa. Code §§ 178.62a, 178.104b
ELIGIBLE FOR MA BUT NO LONGER ELIGIBLE FOR HCBS NOTICE TEXT-EXCESS HOME EQUITY
Until automated notices are available the following text and citations should be printed on the manual Advance Notice sent to the person receiving HCBS as well as all involved parties, informing them that the person is no longer eligible for payment of HCBS:
Because the equity value of your home is $ ____, which exceeds the home
equity limit of $____ you no longer qualify for payment of Home and
Community Based Services (HCBS) beginning on _____.
Beginning on this date, you will need to pay the service provider for the HCBS
you receive. As long as the equity value of your resident property exceeds
$____ you will not qualify for payment of HCBS. If you believe that the
denial of the payment of HCBS will deprive you of medical care, food,
clothing, shelter or other necessities of life which would endanger your
health or life you may ask for an undue hardship waiver.
42 U.S.C. § 1396p(f), 62 P.S. § 441.8 and 55 Pa. Code §§ 178.62a, 178.104b
Issued May 1, 2012