DENIAL OF UNDUE HARDSHIP WAIVER REQUEST NOTICE TEXT-LTC ASSET TRANSFERS
Until automated notices are available the following text and citations should be printed on the manual notice sent to the individual in the LTC facility as well as all involved parties, informing them that the undue hardship waiver was denied:
You previously received a notice stating you would not qualify for payment of
Long Term Care (LTC) facility services for a certain time period because you gave
away or transferred assets for less than fair market value (FMV). You requested
an undue hardship waiver. Your request for an undue hardship waiver is denied.
You remain eligible for all other Medical Assistance benefits.
Citations: 42 U.S.C. § 1396p(c) and 55 Pa. Code § 178.104a
DENIAL OF UNDUE HARDSHIP WAIVER REQUEST NOTICE TEXT-HCBS ASSET TRANSFERS
Until automated notices are available the following text and citations should be printed on the manual notice sent to the individual requesting payment of HCBS as well as all involved parties, informing them that the undue hardship waiver was denied:
You previously received a notice stating you would not qualify for payment of
Home and Community Based Services (HCBS) for a certain time period because
you gave away or transferred assets for less than fair market value (FMV). You
requested an undue hardship waiver. Your request for an undue hardship waiver
is denied. You remain eligible for all other Medical Assistance benefits.
Citations: 42 U.S.C. § 1396p(c) and 55 Pa. Code § 178.104a
DENIAL OF UNDUE HARDSHIP WAIVER REQUEST NOTICE TEXT-LTC EXCESS HOME EQUITY
Until automated notices are available the following text and citations should be printed on the manual notice sent to the individual in the LTC facility as well as all involved parties, informing them that the undue hardship waiver was denied:
You previously received a notice stating you would not qualify for payment of
Long Term Care (LTC) facility services because the equity value of your home
exceeds the home equity limit. You requested an undue hardship waiver. Your
request for an undue hardship waiver is denied. You remain eligible for all other
Medical Assistance benefits.
Citations: 42 U.S.C. § 1396p(f) and 55 Pa. Code § 178.104a
DENIAL OF UNDUE HARDSHIP WAIVER REQUEST NOTICE TEXT-HCBS EXCESS HOME EQUITY
Until automated notices are available the following text and citations should be printed on the manual notice sent to the individual requesting payment of HCBS as well as all involved parties, informing them that the undue hardship waiver was denied:
You previously received a notice stating you would not qualify for payment of
Home and Community Based Services (HCBS) because the equity value of your
home exceeds the home equity limit. You requested an undue hardship waiver.
Your request for an undue hardship waiver is denied. You remain eligible for all
other Medical Assistance benefits.
Citations: 42 U.S.C. § 1396p(f) and 55 Pa. Code § 178.104a
Issued March 12, 2012