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.
(b) The worker must verify resource
eligibility when the individual applies for a State Supplemental Payment.
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 Instruction.
(b) Staff 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 from 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:
(1) provide his or her account statement; or
(2) sign Form 08AD060E, Request for Release of
Information, addressed to the designated financial institution, to authorize
release of account information.
(c) Per Section 4001.1 of Title 56 of the Oklahoma
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 are 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 the account meets exemption criteria before
the funds are exempted from resource and income consideration.
(1) The Oklahoma State Treasurer is responsible for
certifying an ABLE account. The program
name is Oklahoma STABLE. The program is
administered through a partnership with Ohio's STABLE Accounts, backed by
Intuition ABLE Solutions, LLC. ABLE
account rules state:
(A) only individuals whose disability was established
before 26 years of age can set up ABLE Act accounts, and one account is allowed
(B) there is no limit to the number of persons who can
contribute to the ABLE account; and
(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.
(A) 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 $15,000 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 month. The
maximum balance in the ABLE account is $300,000.
(B) When money is withdrawn to pay qualified disability
expenses, the amount withdrawn is excluded from income or resource
(i) The individual must verify, preferably from the
financial institution, that the withdrawn funds were used for qualified
(ii) Funds withdrawn and not used for qualified disability
expenses are considered as income for the month of withdrawal.
(3) Qualified disability expenses
means, expenses related to the eligible individual's blindness or disability
and approved, per 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:
(D) employment, training, and support;
(E) assistive technology and personal support services;
(F) health, prevention and wellness, financial management,
and administrative expenses;
(G) legal fees;
(H) oversight and monitoring; and
(I) funeral and burial expenses.
This is also applicable when both account owners receive SoonerCare. The money in the account is a countable
(b) When the individual dissolves the account
as soon as notified, eligibility is not affected.
(c) When 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.
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.
individual cannot receive the $1,500 revocable burial fund exclusion and an
irrevocable prepaid burial fund exclusion.
For example, when 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.
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
is no maximum face value to receive the irrevocable prepaid burial policy or
contract exclusion. While 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:
(1) $1,500 and 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 countable resource;
(2) $5,500 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 excluded.