H Change in the Penalty Period Example
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H Change in the Penalty Period Example

Programs

Manual Section

ALTCS

MA905

 

Examples

1) Transfer Penalty Period – Full Amount Returned After the Transfer Month

The customer applies for ALTCS in March. He learns that the home he gave to his son three years ago without receiving compensation will result in a transfer penalty period of 19 months and 2 days.

He is approved for ALTCS Acute beginning March 1. To allow his father to qualify for long-term care services, the son transfers the property back to the customer in June. The penalty period ends on May 31, the last day of the month before the property was returned.

 

2) Transfer Penalty Period – Full Amount Returned During Application Period

The customer applies for ALTCS in February. The customer transferred a sports car to his son in January. The transfer will result in a penalty of 13 months and 9 days.

To allow his father to qualify for long-term care services, the customer’s son transfers the title of the vehicle back to the customer. The title transfer is effective February 27.

Since the transfer penalty would have begun in February, and the vehicle was returned in the same month, no transfer penalty is applied.

 

3) Eligibility Ends During Penalty Period - Previous Penalty Expired

The customer applies for ALTCS in June. The customer transferred her home to her brother the year before. The Benefits and Eligibility Specialist determines a transfer penalty of 7 years and 6 months, which will ends in December.

Two years later, the customer’s condition improves, and she is determined medically ineligible. Her ALTCS coverage ends.

Six years later, eight years after the initial application, in June, the customer reapplies and is eligible for ALTCS. Since the previous penalty has already ended, the customer is not penalized any further for the initial transfer. She is eligible for full ALTCS services in the application month.

 

4) Eligibility Ends During Penalty Period - Previous Penalty Active

The customer applies for ALTCS in July 2020. The customer transferred her mobile home to her brother in 2016. The Benefits and Eligibility Specialist determines a transfer penalty of 3 years and 6 months, which will end January 31, 2024.

The customer receives an inheritance in August 2021 that puts her over the resource limit. Her ALTCS coverage ends August 31, 2021.

In December 2023, the customer reapplies but the previous penalty period is still active. The customer is only eligible for ALTCS Acute coverage for December 2023 and January 2024. She is eligible for full ALTCS services in February 2024.