Ch. 10-Non-MAGI Income and Resources Flashcards
What is SOC?
SOC is share of cost, and it is the amount, the MFBU must pay or obligated to the Medicare provider before issuance of Medicare card can be authorized.
How is SOC share of cost determined?
Share of cost (SOC) is determined by gross income minus allowable deductions. This is referred to as NNEI, net non-exempt income.
Then you subtract the maintenance needs income level MNIL from NNEI
The remainder is the SOC.
What must a worker do in order to be able to identify allowable deductions?
The worker must first determine if available, nonexempt income is earned or unearned
If the MFBU includes an aged, blind or disabled, medically needy person ( MN)
If the MFBU includes an LTC (long term care) person
Do all non-magic cases have an SOC?
No, not all non-Magic cases will have an SOC. It will depend on the amount of income in the case, and the size of the MFBU.
When is share of cost (SOC) determined?
Share of cost (SOC) as it is determined at time of application, reapplication, or restoration, and when there’s a change in income, family composition, or any other situation affecting the share of cost
Are there some types of income that are exempt and not counted to compute the share of cost? (SOC)
Yes, some types of earned and unearned income are exempt, and not counted to compute the share of cost
What is real property?
There is real property as in land or improvements. Improvements generally include any immovable property attached to the land. Examples might be timeshares campground memberships, which have real property, deed and assessment are treated as real property. Otherwise they are treated as personal property.
Must property be evaluated?
Yes, property of all eligible and non-eligible MFBU members must be evaluated to determine to know everyone who is applying for Medi-Cal must let us know all property both inside and outside the United States. Which properties to be included in determining Medi-Cal eligibility,
The value of the nonexempt property, what are the total value of the nonexempt property exceeds the property limits.
What if property is unavailable?
If unavailable, then, it is not counted and has no effect on medical eligibility. Make sure to case make sure to comment in case comments.
What is personal property?
Personal property includes possessions or interest exclusive of real property that may be easily transported or stored included, but not limited to cash on hand, bank accounts, notes mortgages deeds of trust, cash, cash, surrender, value of life, insurance, motor vehicles on collect a judgment and interest in a firm and receivership, a lawsuit, patent and copyright
What is exempt property?
Common examples of exempt property are engagement and wedding rings, jewelry for institutionalized individuals, and their spouses heirlooms have been owned in a family for at least two generations, and have intention to be retained by the family in succeeding generations.
Any other with value of $100 or less items used for hobbies household items
One motor vehicle per household is exempt
Business accounts
Home, mobile home, trailer as long as it’s used as a principal residence
Term life insurance that does not have a cash surrender value
Life term with CVS in a whole life insurance as follows if the sum total value of all policies per family member is less than 1500
Burial funds insurance reserved for family members vehicles use for business, self-employment or self support
SSA or SSI retro lump sum payment is exempt for six months after received
What are non-exempt property?
Verification for nonexempt property is required at application anytime it changes reported and redetermination when an item was not previously verify and items have appreciated in value since the last verification
What are unavailable resources?
Unavailable resources are common examples
Pension funds are annuities, IRAs, deferred comp, if receiving periodic payments of interest, and principal, or option to receive periodic
El property will be considered unavailable. If there’s a good faith intent to liquidate the property a good faith intent is demonstrated when the person holds a property for sale by taking all necessary steps of the applicant discontinues, her good faith intent to liquidate the property the property will be considered available.
Property is considered unavailable. If the applicant meets all the following criteria mentally incompetent, there is no spouse or conservator of the state the person acting on the applicants behalf “” key person does not have the right power or authority to access the property.
What is spend down?
Spend down it is a process of reducing one’s non-exempt property to within the property reserve limits by the end of the month to qualify for benefits
What form is given to an applicant regarding spend down?
MC 007 is the form given to applicants and must be documented in case comments that it was given
What is PRINCIPE V BELSHE?
This a provision that is the only way to spend down retroactively that allows a medical applicant to spend excessive property retroactively on qualified medical expenses to establish eligibility for Medi-Cal, beginning the month of application
What are qualified medical expenses for Principe V BELSHE?
These are bills incurred in any month by the individual spouse. Any member of the MFBU or the individuals children who are not a member of the MFBU but are living in the household. The bills have to be unpaid in the same month in which there is also access property for the entire month, beginning the month of application.
Can a property have an encumbrance?
Yes, any type of property may have an encumbrance.
Encumbrances of all non-exempt property that is considered in the property determination must be verified.
Once verification is provided the encumbrance will be deducted from the fair market value.
How are non-exempt vehicles evaluated?
Nonexempt vehicles are valuated by the fair market value minus the encumbrance equals a net market value
What if the applicant does not agree with the fair value determined by using the state department of motor vehicles license fee chart?
The worker will use the following message to determine the market value, including but not limited to the wholesale Kelley blue book
The national auto dealers Association guide
An estimate of value market value obtained by the applicant or beneficiary from a disinterested knowledgeable source, example dealership, mechanic
What happens if the property reserve cannot exceed the limits and it does?
The asset limit is 130,000 for a single household member an additional 65,000 for each additional household member.
An entire month, the MFBU as an eligible to non-magi benefits
During the month, eligible as long as the following conditions are met; the property reserve is reduce within the property limit by the last day of the month, and all other conditions of eligibility or met; example residency linkage, and so on.
For non-magi medical is there an income cap?
No non-magi medical no income caps
Property is looked at for non-medical. There are property limits. Workers must know both property inside and outside of the United States and some customers might have a share of cost.
What type of incomes are there?
There are two types of income earned and unearned
What are examples of earned income?
Gross amount counted. Examples are wages salaries
Commissions
Profits from self-employment
Earned in kind
SDI treated is earned income when received as an eligible AFDC – MN backslash MI person in the MFBU
Temporary workers comp compensation
