No evidence that appellant made transfer with intent other than to assist a specific child in need; medical event that caused appellant’s short-term placement in skilled nursing facility was not reasonably foreseeable; intent behind transfers was not to gain MassHealth eligibility.
Transfer of home to trust within look-back period not disqualifying because the trust then sold the home for fair market value, and then proceeds were used to pay for new house in which Appellant had ownership interest; transfer of $42,000 is disqualifying because insufficient evidence to verify that it was repayment for work on the appellant’s former home.
- Issue is whether Appellant is entitled to an adjustment to the PPA where his spouse was living in an assisted living facility. Appeal denied.
Community spouse did not meet exceptional circumstances criteria for increased Spousal Maintenance Needs Allowance; spouse testified she needed an increase to cover day-to-day bills and to assist her adult disabled child; regulations only allow increase where needs arise from medical condition, frailty, or similar special needs of the community spouse.
Property was transferred before look-back period; attorney’s failure to timely register sale not fatal; evidence was that appellant intended to surrender control of property prior to look-back period.
- Issue is whether the community spouse is entitled to an increase in the spousal maintenance needs allowance, based on exceptional circumstances. Appeal denied.
- Appellant recently gave away or sold assets to become eligible for MassHealth long term care services creating a period of ineligibility. MassHealth ordered to reduce the disqualifying transfer amount by the remaining amount of tax liability paid by the appellant’s daughter and the tax preparation fee. The period of ineligibility is ordered to be redetermined based on the new disqualifying transfer amount.
- Appeals calculation of the PPA. MassHealth ordered to recalculate the PPA because the community spouse needs more income to make mortgage payments.
- Appellant recently gave away or sold assets to become eligible for MassHealth long term care services creating a period of ineligibility. Appeal denied.
- MassHealth denied the Appellant’s application for long term care benefits due to excess assets. Ordered to allocate all income (minus PNA) and excess assets to the Community Spouse and to establish eligibility date consistent with the application date.