Spousal Medicaid Compliant Annuity Win in Pennsylvania

A community spouse's Medicaid Compliant Annuity was incorrectly determined to be a countable resource, and then reversed in light of Weatherbee v. Richman.
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* Medicaid Compliant Annuity

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Aug. 18, 2014 - PRLog -- Pennsylvania community spouse planning using a Medicaid Compliant Annuity is unique, in that they have Operations Memorandum OPS070208 stating that:

"A non-qualified annuity that meets the [requirements of the Deficit Reduction Act of 2005] and provides the community spouse with a monthly income that, when combined with all other available income to the community spouse, is equal to or less than the community spouse monthly maintenance needs allowance, shall be treated as income.  If the combined available income exceeds the community spouse monthly maintenance needs allowance, the annuity shall be treated as an available resource."

Even though we have Weatherbee vyzpt v. Richman (http://www.medicaidannuity.com/weatherbee-v-richman-appeal-brief-u-s-court-of-appeals-3/), we've received word that Pennsylvania caseworkers still at times will follow the Operations Memorandum above.  This is exactly what happened in a recent case that progressed to fair hearing.

In the recent case, a community spouse had purchased an annuity that brought her income to an amount greater than her monthly maintenance needs allowance.  The Medicaid office then denied the Medicaid application due to the married couple having excess resources, in light of the annuity being considered countable.  The family then appealed.

An administrative law judge determined that per Weatherbee v. Richman, a DRA Compliant Annuity (also referred to as a Medicaid Compliant Annuity) shall not be considered as a resource, but as an income stream for the community spouse.  The Medicaid office was found to be incorrect in applying a denial based on excess resources, and the appeal was sustained.

Read the Final Order and Adjudication here. (http://www.medicaidannuity.com/wp-content/uploads/2014/01...)

Cassandra Bishop
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