- 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.
Category: Disqualifying transfer
Appeal 1600798
- Appellant denied for LTC benefits because she did not give MassHealth the information it needed to decide her eligibility within the required time frame. A disqualifying transfer of resources was found as the appellant recently gave away or sold assets to become eligible for MassHealth services. This transfer created a period of ineligibility.
Appeal 1502486
Disqualifying transfer; appellant was the income beneficiary of a Trust that terminated in the same month she was admitted to the nursing facility; termination of the Trust was an action that was “taken to avoid receiving a resource to which the nursing facility resident or spouse is or would be entitled if such action had not been taken.”
Appeal 1406406
Transfers were for less than fair market value; appellant’s brother did not possess a present life estate interest in the trust; the amount transferred to him upon the sale of the property was a disqualifying transfer.
Appeal 1401492
Fair Hearing Rehearing Decision 1401492
Rehearing: MassHealth was correct in determining that the appellant’s assets exceed the limit for MassHealth Standard long term care benefits; MassHealth was correct in its determination there was an impermissible transfer of assets.
Appeal 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
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 1112754
Transfers to appellant’s son of $551,466.94 from appellant’s bank accounts between 6/20/08 and 5/12/10 as well as the payment of $107,433.98 to the son from proceeds of the sale of appellant’s residence on 12/01/10 are disqualifying transfers of a total of $658,900.92; there is no evidenced benefit received by appellant or her spouse for the transfer of $658,900.92 to the son over a two year period; the multiple transfers of money constitute outright gifts and thus multiple disqualifying transfers.
Appeal 1107446
No evidence presented to show that the appellant received fair market value at the time she made the transfers to her son; the payments were done in advance of the services being provided by the appellant’s son; there was no testimony or evidence to demonstrate that this is a typical practice of property management; it is difficult to conclude that the transfers were made exclusively for a purpose other than to qualify for MassHealth when the appellant demonstrated that a contract was entered into after entering a facility and payments were made in advance of services being provided.
Appeal 1009905
Appellant’s withdrawal is a disqualifying transfer; intent and lack of fair market value consideration; appellant had intent to qualify for MassHealth because she was in declining health at the time of the transfer, evidenced by the sale of her home and the need to enter an assisted living center.
MassHealth Appeals 