Appeal 1717373

Fair Hearing Decision 1717373

  • Issue is whether MassHealth applied accurate facts to the controlling regulations when it denied appellant’s application for MassHealth benefits and assessed a period of ineligibility upon determining that appellant had made a disqualifying transfer of assets. MassHealth ordered to rescind denial and re-determine eligibility without any disqualifying transfer period.

Appeal 1215370

Fair Hearing Decision 1215370

Husband’s purchase of an annuity resulted in a transfer of resources for less than fair market value; the Commonwealth is not a remainder beneficiary of this annuity; the regulations plainly allow MassHealth to consider as disqualifying any actions taken by either the applicant or his or her spouse, and, as part of this, to require that annuities purchased by a community spouse comport with the provisions of 130 CMR 520.007(J)(2); the annuity here does not meet those regulatory requirements.

Appeal 1217117

Fair Hearing Decision 1217117

MassHealth determined that appellant’s income flow from the 10-year fixed period annuity is less than it should be based on her life expectancy of 7.59 years; because the current monthly annuity payments do not satisfy 130 CMR 520.007(J)(1) there is a disqualifying transfer of assets; over appellant’s life expectancy she has been and will continue to receive a total of $2051.12 less than the value of the premium paid; $2051.12 represents a disqualifying transfer.

Appeal 1203132

Fair Hearing Decision 1203132

The annuity as initially presented, naming the appellant’s spouse as the remainder beneficiary in the first position, does satisfy the MassHealth regulations and is acceptable to MassHealth; through a notice dated April 11, 2012 MassHealth approved the appellant’s LTC application effective December 2, 2011 as requested by the nursing facility.