DENIAL OF UNDUE HARDSHIP WAIVER REQUEST NOTICE TEXT-LTC ASSET TRANSFERS
When an undue hardship is denied for an expired penalty period, 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
because you did not prove that the denial of the payment of LTC services
will deprive you of medical care such that your health or life would be endangered,
or you will be deprived of food, clothing, shelter or other necessities of life.
You remain eligible for all other Medical Assistance benefits.
Citations: 42 U.S.C. § 1396p(c) and 55 Pa. Code § 178.104a, 178.104b
DENIAL OF UNDUE HARDSHIP WAIVER REQUEST NOTICE TEXT-HCBS ASSET TRANSFERS
When an undue hardship is denied for an expired penalty period, 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 because you did not prove that the denial of the payment of HCBS
services will deprive you of medical care such that your health or life would be endangered,
or you will be deprived of food, clothing, shelter or other necessities of life.
You remain eligible for all other Medical Assistance benefits.
Citations: 42 U.S.C. § 1396p(c) and 55 Pa. Code § 178.104a, 178.104b
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 because you did not prove that the denial of the payment of LTC services will deprive you of medical care such that your health or life would be endangered, or you will be deprived of food, clothing, shelter or other necessities of life.
You remain eligible for all other Medical Assistance benefits.
Citations: 42 U.S.C. § 1396p(f) and 55 Pa. Code § 178.104a , 178.104b
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 because you did not prove that the denial of the payment of HCBS services will deprive you of medical care such that your health or life would be endangered, or you will be deprived of food, clothing, shelter or other necessities of life.
You remain eligible for all other Medical Assistance benefits.
Citations: 42 U.S.C. § 1396p(f) and 55
Pa. Code §
178.104a , 178.104b
Updated March 14, 2023, replacing March 12, 2012