405 Ind. Admin. Code 2-3-2

Current through October 9, 2024

Section 405 IAC 2-3-2 - Life care contracts

Authority: IC 12-15

Affected: IC 12-13-7-3; IC 12-15

Sec. 2.

(a) An applicant who has entered into a life care contract with an institution whereby he or she has transferred his or her available assets to the institution in exchange for full maintenance and medical care during his or her lifetime in that institution is ineligible for Medicaid for the aged, blind, or disabled unless the contracting institution can prove to the division by a complete and accurate accounting of all funds involved that it is unable to fulfill its contract obligations to the applicant.

(b) For purposes of determining an individual's eligibility for, or an amount of, benefits under this article, when an applicant or member residing in a continuing care retirement community or similar life care community collects an entrance fee on admission from such individual the fee shall be considered an available resource to the extent that:

(1) an individual who has the ability to use the entrance fee, or should the contract provide that the entrance fee may be used, to pay for care should other resources or income of the individual be insufficient to pay for such care;

(2) the individual is eligible for a refund of any remaining entrance fee when the individual dies or terminates the continuing care retirement community or life care community contract and leaves the community; and

(3) the entrance fee does not confer an ownership interest in the continuing care retirement community or life care community.

405 IAC 2-3-2

Office ofthe Secretary of Family and Social Services; 405 IAC 2-3-2; filed Mar 1, 1984, 2:31 p.m.: 7 IR 1018, effApr 1, 1984; readopted filed Jun 27, 2001, 9:40 a.m.: 24 IR 3822; readopted filed Sep 19, 2007, 12:16p.m.: 20071010-IR-405070311RFA; filed Aug 18, 2009, 11:33 a.m.: 20090916-IR-405080325FRA; readopted filed Oct 28, 2013, 3:18 p.m.: 20131127-IR- 405130241RFA

Readopted filed 11/13/2019, 11:54 a.m.: 20191211-IR-405190487RFA

Filed 6/11/2021, 2:35 p.m.: 20210707-IR-405190602FRA

Transferred from the Division of Family and Children ( 470 IAC 9.1-3-4) to the Office of the Secretary of Family and Social Services ( 405 IAC 2-3-2) by P.L. 9-1991, SECTION 131, effective January 1, 1992.