The hearing officer ruled that the primary beneficiary of a spousal annuity does not have to be “Commonwealth of Massachusetts” without limiting language. Since the MassHealth regulation only allows estate recovery to the extent of MassHealth benefits correctly paid, the beneficiary language can be limited to track the regulation.
Appellant purchased annuity; was not disqualifying transfer because it occurred before the look-back period.
- Issue is whether MassHealth was correct in determining the appellant’s MassHealth start date. Ordered to change start date.
- 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.
- Issue is whether MassHealth was correct in determining the appellant’s MassHealth benefits start date. Appeal approved to change the appellant’s start date.
- Appellant purchased an annuity that lasts beyond the appellant’s life expectancy, and therefore made a disqualifying transfer of assets resulting in a period of ineligibility. Appeal denied.
- Appellant’s long-term care application denied because MassHealth determined there had been a disqualifying resource transfer (this resulted in an ineligibility period). The transfer was an annuity which was a private, inter-family, unsecured agreement found to be disqualifying.
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.
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.
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.