NDAC 75-02-02.1-28
Excluded assets
Cite as N.D. Admin. Code ยง 75-02-02.1-28
Except as provided in section 75-02-02.1-28.1, the following types of assets will be excluded in
determining if the available assets of an applicant or recipient exceed asset limits:
1.
The home occupied by the Medicaid unit, including trailer homes being used as living
quarters.
2.
Personal effects, wearing apparel, household goods, and furniture.
3.
One motor vehicle.
4.
Indian trust or restricted lands and the proceeds from the sale thereof, so long as those
proceeds are impressed with the original trust.
5.
Indian per capita funds and judgment funds awarded by either the Indian claims commission
or the court of claims after October 19, 1973, interest and investment income accrued on such
Indian per capita or judgment funds while held in trust, and purchases made using interest or
investment income accrued on such funds while held in trust. The funds must be identifiable
and distinguishable from other funds. Commingling of per capita funds, judgment funds, and
interest and investment income earned on those funds, with other funds, results in loss of the
exemption.
6.
a.
In determining the eligibility of an individual with respect to skilled nursing services,
swing-bed, or home and community-based benefits, the individual will be ineligible for
those Medicaid benefits if the individual's equity interest in the individual's home exceeds
five hundred thousand dollars.
b.
The dollar amount specified in this subsection will be increased, beginning with 2011,
from year to year based on the percentage increase in the consumer price index for all
urban consumers, all items, United States city average, rounded to the nearest one
thousand dollars.
c.
This subsection does not apply to an individual whose spouse, or child who is under age
twenty-one or is blind or disabled, lawfully resides in the individual's home.
d.
This subsection may not be construed as preventing an individual from using a reverse
mortgage or home equity loan to reduce the individual's total equity interest in the home.
e.
This subsection applies only to individuals who made application for Medicaid with
respect to skilled nursing facility services, swing-bed, or home and community-based
benefits on or after January 1, 2006.
7.
a.
Notwithstanding any other provision to the contrary, the assets of an individual must be
disregarded when determining Medicaid eligibility in an amount equal to the insurance
benefit payments that are made to or on behalf of an individual who is a beneficiary
under a long-term care insurance policy that:
(1)
Covers an insured who was a resident of North Dakota when coverage first became
effective under the policy;
(2)
Is a qualified long-term care insurance policy, as defined in section 7702B(b) of the
Internal Revenue Code of 1986, issued not earlier than the effective date of the
state plan amendment described in subdivision b;
(3)
The agency determines meets the requirements of the long-term care insurance
model regulations and the long-term care insurance model act promulgated by the
national association of insurance commissioners as adopted as of October 2000, or
the state insurance commissioner certifies that the policy meets such requirements;
and
(4)
Is sold to an individual who:
(a)
Has not attained age sixty-one as of the date of purchase, if the policy provides
compound annual inflation protection;
(b)
Has attained age sixty-one but has not attained age seventy-six as of the date
of purchase, if the policy provides some level of inflation protection; or
(c)
Has attained age seventy-six as of the date of purchase.
b.
This subsection applies only to individuals who have purchased a long-term care
insurance policy described in this subsection with an issue date on or after the date
specified in an approved Medicaid state plan amendment that provides for the disregard
of assets:
(1)
To the extent that payments are made under such a long-term care insurance
policy; or
(2)
Because an individual has received or is entitled to receive benefits under such a
long-term care insurance policy.
8.
Property that is essential to earning a livelihood.
a.
Property may be excluded as essential to earning a livelihood only during months in
which a member of the Medicaid unit is actively engaged in using the property to earn a
livelihood, or during months when the Medicaid unit is not actively engaged in using the
property to earn a livelihood, if the Medicaid unit shows that the property has been in
such use and there is a reasonable expectation that the use will resume:
(1)
Within twelve months of the last use; or
(2)
If the nonuse is due to the disabling condition of a member of the Medicaid unit,
within twenty-four months of the last use.
b.
Property consisting of an ownership interest in a business entity that employs anyone
whose assets are used to determine eligibility may be excluded as property essential to
earning a livelihood if:
(1)
The individual's employment is contingent upon ownership of the property; or
(2)
There is no ready market for the property.
c.
A ready market for property consisting of an ownership interest in a business entity exists
if the interest may be publicly traded. A ready market does not exist if there are
unreasonable limitations on the sale of the interest, such as a requirement that the
interest be sold at a price substantially below its actual value or a requirement that
effectively precludes competition among potential buyers.
d.
Property currently enrolled in the conservation reserve program is considered to be
property essential to earning a livelihood.
e.
Property from which a Medicaid unit is receiving only rental or lease income is not
essential to earning a livelihood.
f.
Liquid assets, to the extent reasonably necessary for the operation of a trade or
business, are considered to be property essential to earning a livelihood. Liquid assets
may not otherwise be treated as essential to earning a livelihood.
9.
Property which is not saleable without working an undue hardship. Such property may be
excluded no earlier than the first day of the month in which good-faith attempts to sell are
begun, and continues to be excluded only for so long as the asset continues to be for sale and
until a bona fide offer for at least seventy-five percent of the property's fair market value is
made. Good-faith efforts to sell must be repeated at least annually in order for the property to
continue to be excluded.
a.
Persons seeking to establish retroactive eligibility must demonstrate that good-faith
efforts to sell were begun and continued in each of the months for which retroactive
eligibility is sought. Information concerning attempts to sell, which demonstrate that an
asset is not saleable without working an undue hardship, are relevant to establishing
eligibility in the month in which the good-faith efforts to sell are begun, but are not
relevant to months prior to that month and do not relate back to prior months.
(1)
A good-faith effort to sell real property or a mobile home must be made for at least
three calendar months in which no bona fide offer for at least seventy-five percent of
the property's fair market value is received before the property can be shown to be
not saleable without working an undue hardship. The three calendar months must
include a good-faith effort to sell through the regular market for three calendar
months.
(2)
A good-faith effort to sell property other than real property, a mobile home, or an
annuity must be made for at least thirty days in which no bona fide offer for at least
seventy-five percent of the property's fair market value is received before the
property can be shown to be not saleable without working an undue hardship.
b.
Property may not be shown to be not saleable without working an undue hardship if the
owner of the property fails to take action to collect amounts due and unpaid with respect
to the property or otherwise fails to assure the receipt of regular and timely payments due
with respect to the property.
10.
a.
Any pre-need burial contracts, prepayments, or deposits up to the amount set by the
department in accordance with state law and the Medicaid state plan, which are
designated by an applicant or recipient for the burial of the applicant or recipient.
Earnings accrued on the total amount of the designated burial fund are excluded.
(1)
The burial fund must be identifiable and irrevocable.
(2)
The value of an irrevocable burial arrangement shall be considered toward the
burial exclusion.
(3)
The prepayments on a whole life insurance policy or annuity are the lesser of the
face value or the premiums that have been paid.
(4)
Any fund, insurance, or other property given to another person or entity in
contemplation that its value will be used to meet the burial needs of the applicant or
recipient must be irrevocable.
(5)
An applicant shall be determined eligible for the three-month prior period when a
burial fund is established at the time of application if the value of all assets are
within the Medicaid burial fund exclusion and asset limit amounts for each of the
three prior months. Future earnings on the newly established burial fund must be
excluded.
b.
A burial plot for each family member.
11.
Home replacement funds, derived from the sale of an excluded home, and if intended for the
purchase of another excluded home, until the last day of the third month following the month
in which the proceeds from the sale are received. This asset must be identifiable and not
commingled with other assets.
12.
Unspent assistance, and interest earned on unspent assistance, received under the Disaster
Relief and Emergency Assistance Act of 1974 [Pub. L. 93-288] or some other federal statute,
because of a presidentially declared major disaster, and comparable disaster assistance
received from a state or local government, or from a disaster assistance organization. This
asset must be identifiable and not commingled with other assets.
13.
Payments, interest earned on the payments, and in-kind items received for the repair or
replacement of lost, damaged, or stolen exempt or excluded assets are excluded for nine
months, and may be excluded for an additional twenty-one months, if circumstances beyond
the person's control prevent the repair or replacement of the lost, damaged, or stolen assets,
and keep the person from contracting for such repair or replacement. This asset must be
identifiable and not commingled with other assets.
14.
For nine months, beginning after the month of receipt, unspent assistance received from a
fund established by a state to aid victims of crime, to the extent that the applicant or recipient
demonstrates that such amount was paid in compensation for expenses incurred or losses
suffered as a result of a crime. This asset must be identifiable and not commingled with other
assets.
15.
Payments from a fund established by a state as compensation for expenses incurred or
losses suffered as a result of a crime. This asset must be identifiable and not commingled with
other assets.
16.
Payments made pursuant to the Confederate Tribes of the Colville Reservation Grand Coulee
Dam Settlement Act, [Pub. L. 103-436; 108 Stat. 4577 et seq.]. This asset must be identifiable
and not commingled with other assets.
17.
Stock in regional or village corporations held by natives of Alaska issued pursuant to section 7
of the Alaska Native Claims Settlement Act, [Pub. L. 92-203; 42 U.S.C. 1606].
18.
For nine months beginning after the month of receipt, any educational scholarship, grant, or
award and any fellowship or gift, or portion of a gift, used to pay the cost of tuition and fees at
any educational institution. This asset must be identifiable and not commingled with other
assets.
19.
For nine months beginning after the month of receipt, any income tax refund, any earned
income tax credit refund, or any advance payments of earned income tax credit. This asset
must be identifiable and not commingled with other assets.
20.
Assets set aside, by a blind or disabled, but not an aged, supplemental security income
recipient, as a part of a plan to achieve self-support which has been approved by the social
security administration.
21.
The value of a life estate.
22.
Allowances paid to children of Vietnam veterans who are born with spina bifida. This asset
must be identifiable and not commingled with other assets.
23.
The value of mineral acres.
24.
Funds, including interest accruing, maintained in an individual development account
established under title IV of the Assets for Independence Act, as amended [Pub. L. 105-285;
42 U.S.C. 604, note].
25.
Property connected to the political relationship between Indian tribes and the federal
government which consists of:
a.
Any Indian trust or restricted land, or any other property under the supervision of the
secretary of the interior located on a federally recognized Indian reservation, including
any federally recognized Indian tribe's pueblo or colony, and including Indian allotments
on or near a reservation as designated and approved by the bureau of Indian affairs of
the department of interior.
b.
Property located within the most recent boundaries of a prior federal reservation,
including former reservations in Oklahoma and Alaska native regions established by the
Alaska Native Claims Settlement Act.
c.
Ownership interests in rents, leases, royalties, or usage rights related to natural
resources (including extraction of natural resources or harvesting of timber, other plants
and plant products, animals, fish, and shellfish) resulting from the exercise of federally
protected rights.
d.
Property with unique Indian significance such as ownership interests in or usage rights to
items not covered by subdivisions a through c that have unique religious, spiritual,
traditional, or cultural significance, or rights that support subsistence or a traditional
lifestyle according to applicable tribal law or custom.
26.
Funds held in retirement plans that are considered qualified retirement plans in the Internal
Revenue Code [26 U.S.C.].
27.
A charitable gift annuity that is irrevocable and may not be assigned to another person.