Medicare-Medicaid Pay-Down of Assets
State law and regulations impose income and asset limits on persons applying for Medicaid.
The income limit for the institutional Medicaid program and certain home and community-based waiver programs is determined by the HUSKY Health Program. For 2025, the Medicaid income limit for individuals eligible for the Nursing Home (institutional) program is $2,829 per month. Asset limits for a single person or a couple applying together is $1,600. When only one spouse is applying, the asset limit is now based on the Community Spousal Protected Amount (CPSA) which is $157,920 for 2025. Connecticut residents aged 65 or older, who are aged 18-64 and who are blind or have another disability, may qualify for Medicaid coverage under HUSKY C.
An assistance unit member residing in or admitted to a rated housing facility or a licensed residential care home shall be subject to a penalty, if such member:
(i) transfers an asset, other than an asset excluded from eligibility determinations under any provision of section 17b-198-8 of the Regulations of Connecticut State Agencies, for the purpose of establishing or maintaining eligibility for assistance pursuant to SAGA, and
(ii) such transfer occurred during the twenty-four month period immediately preceding the date of application for assistance, while an application for such assistance was pending or while such member was receiving such assistance.
The department shall investigate the circumstances under which an asset was transferred if such asset was transferred during any time period set forth in this subparagraph.
An assistance unit member’s placement of an asset into joint ownership with another person, including such member’s spouse, shall be considered a transfer within the meaning of this subdivision if such person subsequently transfers or otherwise liquidates such asset, or if such member subsequently grants full ownership of such asset to such person. The date of transfer in such a situation shall be the date such person transferred or otherwise liquidated such asset, or was granted full ownership of such asset by the assistance unit member, whichever occurs first.
The department shall impose a penalty when an assistance unit member residing in or admitted to a rated housing facility or a licensed residential care home transfers non-home property excluded pursuant to subdivision (8) of subsection (d) of section 17b-198-8 of the Regulations of Connecticut State Agencies for the purpose of establishing or maintaining eligibility for assistance pursuant to SAGA during any period of time.
The department shall consider an asset to have been transferred for the purpose of establishing or maintaining eligibility for assistance pursuant to SAGA if:
(i) Fair market value was not received for such asset;
(ii) there is no convincing evidence that the transfer was for another purpose; and
(iii) the transferor did not retain funds sufficient to account for the transferor’s foreseeable needs.
In determining whether fair market value was received as compensation for a transferred asset, the department shall consider any compensation received at the time of or after the transfer. The department shall consider compensation received prior to the transfer only if such compensation was received in accordance with a legally enforceable agreement, or in the form of services or payment for services that were:
(i) Of the type provided by a homemaker or a home health aide;
(ii) essential to avoid the transferor’s institutionalization; and
(iii) either provided by the transferee while sharing the home of the transferor or paid for by the transferee.
Any non-monetary compensation received shall be assigned a monetary value for the purpose of determining whether such compensation constituted fair market value for the transferred asset. A monetary value shall be assigned for services of the type normally rendered by a homemaker or home health aide according to the current state minimum hourly wage for such services. For all other services provided as compensation at the time of transfer, after the transfer or in connection with a legally enforceable agreement, a monetary value shall be assigned according to the actual cost of the services. Any compensation received in the form of real or personal property shall be valued according to such property’s fair market value. Compensation in the form of a note of indebtedness shall be valued according to the total amount owed on such note. An out-of-pocket payment by the transferee may include payment for alterations to the transferor’s home that are necessary to allow the transferor to continue to use such home and avoid institutionalization.