ELIGIBLE FOR MA BUT NO LONGER ELIGIBLE FOR LTC NOTICE TEXT- RECIPIENT ASSET TRANSFERS
When a manual notice is necessary, the following text and citations should be printed on the manual advance notice sent to the individual in the LTC facility as well as all involved parties, informing them that the individual is no longer eligible for payment of LTC facility services:
You no longer qualify for payment of services in an LTC facility beginning on _________ and ending on __________ because
you gave away or transferred a total of _________ in assets for less
than fair market value.
During this time period, you will need to pay the LTC facility for the LTC
services you receive. You continue to qualify for other MA benefits.
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,
ELIGIBLE FOR MA BUT NO LONGER ELIGIBLE FOR HCBS NOTICE TEXT-RECIPIENT ASSET TRANSFERS
When a manual notice is necessary, the following text and citations should be printed on the manual advance notice sent to the individual receiving HCBS as well as all involved parties, informing them that the individual is no longer eligible for payment of HCBS:
You no longer qualify for payment of HCBS beginning on __________ and ending on __________ because
you gave away or transferred a total of __________ in assets for less than fair market value.
During this time period, you will need to pay the service provider
for the HCBS you receive. You continue to qualify for other MA benefits.
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, 255.4
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 individual residing in an LTC facility as well as all involved parties, informing them that the individual 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 an
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, 255.4
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 individual receiving HCBS as well as all involved parties, informing them that the individual 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, 255.4
Updated March 14, 2023, replacing March 12, 2012