Library: Policy
317:35-5-41.9. Exclusions from resources
Rule text available at Oklahoma Health Care Authority website.
INSTRUCTIONS TO STAFF 317:35-5-41.9
Revised 11-22-21
1. Proceeds from a reverse mortgage or a deferred payment loan are treated as a loan. If the proceeds are not spent or encumbered within 90-calendar days of receiving the proceeds, these funds are considered a countable resource. Examples of an encumbrance are loans for home repairs, remodeling, or personal expenses. If the proceeds are used to purchase an income producing resource, such as an annuity or certificate of deposit, the income and interest are counted as income.
2. (a) The Oklahoma State Treasurer is responsible for certifying an achieving a better life experience (ABLE) account through the Oklahoma STABLE program. The Oklahoma STABLE program is administered through a partnership with Ohio's STABLE Accounts. ABLE account rules state:
(1) only individuals whose disability was established before 26 years of age can set up an ABLE account and only one account is allowed per individual;
(2) there is no limit to the number of individuals who can contribute to the ABLE account; and
(3) upon the death of an ABLE participant, qualified disability expenses (QDE) may be paid from the account. All remaining funds in the account must be paid to the state Medicaid agency to repay costs of care received by the participant up to the amount of Medicaid paid after establishment of the ABLE account.
(b) Centers for Medicare and Medicaid Services (CMS) guidance states that, per Section 103 of the ABLE Act, contributions to an ABLE account, distributions from the account for QDE, and the account balance are disregarded in determining the individual's SoonerCare (Medicaid) eligibility. This disregard also applies to the ABLE accounts of individuals whose income or resources are deemed available to a SoonerCare (Medicaid) applicant who receives Supplemental Security Income (SSI), such as a spouse.
(c) Any money deposited in the ABLE account in a calendar year that is in excess of the annual federal gift tax exclusion is considered a countable resource. A distribution from an ABLE account is only considered a countable resource when it is retained after the distribution month and is used for a non-QDE. Distributions are never considered countable income. The current gift tax exclusion amount is $15,000 per calendar year and the maximum balance in an ABLE account is $468,000. Refer to okstable.org for current eligibility information.
(d) When an individual receives SSI and his or her ABLE account balance exceeds $100,000, the Social Security Administration suspends the individual's SSI income based on excess resources. When this occurs, the individual continues to be eligible for SoonerCare (Medicaid) benefits.
(e) Once the individual provides documents that verify the ABLE account is valid, no further account verification is required. When the individual receives SSI and is passively renewed, no further inquiry regarding the ABLE account is made at renewal. At renewal, when the individual does not receive SSI, the worker asks if the account is still open and if he or she believes the deposits in and expenditures from the account are in compliance with the terms and requirements of that particular 529 account. When the individual answers yes, no further inquiry is needed.
3. Contributions made to an ABLE account by the parent(s) of the individual with the ABLE account are not considered transfers of assets without commensurate return if the parent(s) later applies for long term care services. Parents are able to transfer their assets to their disabled child of any age without it affecting their eligibility for long term care. However, when any person other than the parent(s) of the individual with the ABLE account makes a contribution to the ABLE account and later applies for long term care services, the worker must determine if the transfer of assets without commensurate return rule applies to the contribution.
4. Refer to Instruction to Staff #2(c) of this Section.
