Medicare-Medicaid Pay-Down of Assets
State law and regulations impose income and asset limits on persons applying for Medicaid.
In Colorado, Medicaid is called Health First Colorado and is administered by the Colorado Department of Health Care Policy & Financing. The primary program is the Elderly, Blind and Disabled (EBD) Waiver, which provides services to disabled individuals and seniors living at home and in assisted living facilities to promote independent living and prevent premature nursing home placements. Assistance may include adult day care, personal care assistance, home modifications, personal emergency response systems, and more. In order to be enrolled in EBD individuals must:
- either be 65 years of age and older with a functional impairment,
- be currently residing in, or be at risk of being institutionalized in a nursing facility or hospital
- have an income less than 300% (3 times) the Supplemental Security Income allowance per month
- have countable resources less than $2000 for a single person or $3000 for a couple.
An individual, or the spouse of such individual, who is an applicant or recipient of either institutional Medicaid or home and community-based waiver services, who transfers an asset at any time on or after the “look-back date,” for less than fair market value for the purpose of establishing or maintaining eligibility will cause the individual to be charged with the difference between the fair market value of the asset and the amount of any compensation received. The “look-back date” for an institutionalized individual is the date that is 60 months immediately prior to the later of the first day of the month of the original, initial application. For individuals receiving home and community-based waiver services, the “look-back date” is the date that is 60 months immediately prior to the later of the first day of the month of the original, initial application or the first day of the month in which the individual disposes of assets for less than fair market value. For transfers relating to trusts, annuities, or similar legal instruments, the “look-back date” is 60 months.