Ohio Medicaid Rules

 

OHIO: Medicaid Guidelines for using Spend Down Funds for Burial Assets:

  • You can purchase Burial Trusts for the Medicaid INDIVIDUAL & THEIR SPOUSES
  • You can purchase Burial Trusts for each of the CHILDREN & STEP-CHILDREN
  • You can purchase Burial Trusts for each of the CHILDREN'S & STEP-CHILDREN'S SPOUSES

OAC 5160:1-3-05.7 Medicaid: burial spaces.

(A)·This rule describes the treatment of burial spaces for the purposes of determining eligibility for medical assistance.

(B)·Definitions.

(1)·"Agreement," for the purpose of this rule, means a contract with a burial provider for a burial space held for the individual or a member of the individual's immediate family.

(2)·"Burial space," means a burial plot, gravesite, crypt, mausoleum, casket, urn, niche, or other repository customarily and traditionally used for the deceased's bodily remains. The term also includes a contract for care and maintenance of the gravesite, sometimes referred to as an endowment or perpetual care and necessary and reasonable improvements or additions to such spaces, including but not limited to vaults, headstones, markers, or plaques, burial containers (e.g., for caskets) and arrangements for the opening and closing of the gravesite.

(3)·"Immediate family" includes the individual's:

(a)·Parents, including adoptive parents;

(b)·Minor or adult children, including adoptive and stepchildren;

(c)·Siblings, including adoptive and stepsiblings; or

(d)·Spouses of immediate family if the marriage is in effect at the time of determination or renewal of eligibility for medical assistance.

(C)·A burial space or burial space contract, described in rule 5160:1-3-05.6 of the Administrative Code which represents the purchase of a burial space held for the burial of the individual, the individual's spouse, or any other member of the individual's immediate family is an excluded resource, regardless of value.

(D)·A burial space is held for an individual when someone currently has:

(1)·Title to and/or possesses a burial space intended for the individual's use (e.g., has title to a burial plot or owns a burial urn stored for his own use); or

(2)·A contract with a funeral service company for specified burial spaces for the individual's burial (i.e., an agreement which represents the individual's current right to the use of the items at the amount shown).

(E)·Until the purchase price is paid in full, a burial space is not held for an individual under an installment sales contract or similar device and the installment payments shall be considered burial funds in accordance with rule 5160:1-3-05.6 of the Administrative Code.·

(F)·Administrative agency responsibilities. The administrative agency shall:

(1)·Determine whether the burial space is held for the individual or member of the individual's immediate family if the agreement shows the purchase of a specified burial space at a specified price.

(2)·Of items that serve the same purpose, exclude only one per person. For example, exclude a cemetery lot and a casket for the same person, but not a casket and an urn.

(3)·If the agreement calls for installment payments, determine whether the value of the burial space must be treated as burial funds in accordance with rule 5160:1-3-05.6 of the Administrative Code.

Replaces: 5160:1-3- 05.7

Effective: 8/1/2016
Five Year Review (FYR) Dates: 08/01/2021
Promulgated Under:·111.15
Statutory Authority:·5160.02,·5163.02
Rule Amplifies:·5160.02,·5163.02
Prior Effective Dates: 9/3/77, 2/1/79, 10/1/79, 1/3/80, 12/1/84 (Emer.), 2/10/85, 9/1/94, 10/2/14

Check with your state's Medicaid office and or your Attorney about state specific Spend Down Rules.

NOTE: Section 5106:1-3-05.6-D Specifies:

(D) Irrevocable prepaid burial contracts.
(1) Irrevocable prepaid burial contracts are not a resource.
(2) Any portion of the contract that represents burial funds reduces the amount available under the burial funds exclusion described in paragraph (C) of this rule.
(3) Any portion of the contract that represents the purchase of burial spaces has no effect on the burial funds exclusion.
Link to the FULL Section 5106:1-3-05.6-D

The Medicaid program helps pay for long term care (nursing home, assisted living, or in-home care) for many seniors. The Medicaid rules allow the patient and the patient’s spouse to keep certain amounts of their savings and certain amounts from their monthly income. As of January 2017, Ohio’s Medicaid program allows the following amounts:

State Ohio
Individual Countable Resource Allowance (ICRA) $2,000
Countable Resource Allowance (Both Spouses in Institution) $3,000
Community Spouse Resource Minimum Allowance (CSRA) $24,180
Community Spouse Resource Maximum Allowance (CSRA) $120,900
Divestment Penalty Divisor $6,570 / Month
Income-Cap State YES - $2,205 / Month
Personal Needs Allowance (PNA) $50 / Month
Monthly Maintenance Needs Minimum Allowance (MMNA) $2,003 / Month
Monthly Maintenance Needs Maximum Allowance (MMNA) $2,003 / Month
Shelter Standard $601 / Month
Utility Allowance $510 / Month
Uses Social Security Life Expectancy YES
Updated 1/18/2017