INSTRUCTIONS TO STAFF 317:35-5-41.2
Effective October 1, 2015, Oklahoma became a Supplemental Security Income (SSI)
criteria state. As such, when the
individual receives SSI and applies only for Medicaid benefits, the worker is
not responsible for verifying the individual's resource eligibility unless he
or she provides questionable information.
This may occur when the individual reports owning property or liquid
resources in excess of the applicable resource standard per Appendix C-1,
Maximum Income, Resource, and Payment Standards.
worker must verify resource eligibility when the individual applies for a State
2. (a) The
individual's statement that he or she does not have money on hand or in a
financial institution is sufficient unless there are contrary indications. When there is contrary information or the
individual does not have records to verify the amount in a financial
institution, the worker obtains verification from the financial institution,
when not verified through the Oklahoma
Health Authority (OHCA) Asset Verification System (AVS) per (b) of this
may verify account information at financial institutions electronically through
OHCA AVS. When the account is verified
through OHCA AVS additional verification is not needed, unless different than
normal deposits and withdrawals are seen.
When the account is not verified through OHCA AVS, the worker may verify
account information by requesting the individual:
his or her account statement; or
Form 08AD060E, Request for Release of Information, addressed to the designated
financial institution, to authorize release of account information.
Per Section 4001.1 of Title 56 of the Oklahoma Statutes (56 O.S. §
4001.1) money and assets in an individual savings or
trust account owned by the designated beneficiary of the account and
established to pay qualified disability expenses is excluded per the Oklahoma
Achieving a Better Life Experience (ABLE) Program or an ABLE program in any
other state for the purpose of determining eligibility to receive, or the
amount of any assistance or benefits, from local or state means-tested
programs. An individual may only have
one ABLE account. The individual must
provide documents to verify that the account meets exemption criteria
before the funds are exempted from resource and income consideration.
The Oklahoma State Treasurer is responsible for certifying an ABLE
account. Rules regarding an ABLE account
only individuals whose disability was established before 26 years of age can
set up ABLE Act accounts and one account is allowed per individual;
there is no limit to the number of persons who can contribute to the ABLE
(C) upon the death of an ABLE Act participant, every dollar
remaining in the account must be paid to the state Medicaid agency to repay
costs of care received by the individual during life, up to the amount Medicaid
(2) At application and renewal,
the individual must provide proof from the financial institution of the
dates and amounts of money deposited into and withdrawn from the ABLE
account in the last 12 months.
The exemption from income and resource consideration applies to money deposited
in the account up to the annual federal gift tax exclusion per Section 2503(b)
of Title 26 of the United States Code.
The current gift tax exclusion amount is $14,000 per
calendar year. Any money deposited in the account in a calendar year
that is in excess of the annual federal gift tax exclusion is considered as
countable income in the month deposited and as a resource for the following
money is withdrawn to pay qualified disability expenses, the amount withdrawn
is excluded from income or resource consideration.
(i) The individual
preferably from the financial institution, that the withdrawn funds were used
for qualified disability expenses.
(ii) Funds withdrawn and not used
for qualified disability expenses are considered as income for the month of
Qualified disability expenses means, any expenses related to the eligible
individual's blindness or disability and approved under Section 529A of the
Internal Revenue Code that are made for the benefit of an eligible individual
who is the designated beneficiary including, but not limited to, expenses for:
employment, training, and support;
assistive technology and personal support services;
health, prevention and wellness, financial management, and administrative
oversight and monitoring; and
funeral and burial expenses.
3. (a)This is
also applicable when both account owners receive SoonerCare. The money in the account is a countable
the individual dissolves the account as soon as notified, eligibility is not
both account holders receive SSI, they may share a joint account. The worker only considers each individual’s
share of the account in determining his or her eligibility.
4. Examples of funds set aside for burial may include savings or checking accounts, a certificate of deposit, or cash, when the money is clearly designated as being set aside for the individual’s burial.
5. The individual cannot receive a $1,500 revocable burial fund exclusion and an irrevocable prepaid burial fund exclusion. For example, if an individual has revocable burial funds of $4,500 and does not have other funds set aside for burial, the worker considers $3,000 of the cash value as a countable resource.
6. Per the
Oklahoma State Insurance Commission, a funeral home cannot be the beneficiary
of a life insurance policy used to fund a burial contract. When the individual uses life insurance to
fund a burial contract, there must be an irrevocable agreement between the
individual and the insurance company.
This is in addition to the prepaid burial contract that must also be
7. There is no maximum face value to receive the irrevocable prepaid burial policy or contract exclusion. As long as it is irrevocable it is excluded.
8. All life insurance policies must be
considered in determining the amount that must be counted toward the resource
limit. A life insurance policy that has
a face value less than $1,500 cannot have a separate exemption per (c) of this
Section. For example, when the
individual has life insurance with a cash value of:
and he or she has an irrevocable prepaid burial policy with a face value of
$10,000, the worker considers the $1,500 cash value life insurance policy as a
and an irrevocable prepaid burial policy with a face value of $10,000, the
worker considers the $5,500 life insurance as a countable resource. In this
example, the individual is not resource eligible for SSP, but meets resource
standards for Qualified Medicare Beneficiary Plus benefits, when this is the
only resource; or
(3) $750, a
second life insurance policy with a cash value of $500, and an irrevocable
prepaid burial policy with a face value of $15,000, the $1,250 in cash value
life insurance is a countable resource and the irrevocable prepaid burial is