HFS 2538 A

Healthcare and Family Services (HFS) has special rules for considering the income and resources of a married couple when one of them applies for or receives Community Care Program (CCP) services through the Department on Aging (DoA). HFS also has special rules for treating resources transfers when a person (single or married) applies for or receives CCP services through DoA.

When you apply for or receive CCP services or when either you or your spouse request, the Department of Human Services (DHS), local Family Community Resource Center (FCRC) will determine the value of your resources. Resources may include, but are not limited to, bank accounts, certificates of deposit, stocks, trusts and prepaid burial plans. This determination will help you plan how you will handle your resources now that you have applied for or receive CCP services through DoA. You do not need to apply for assistance to request this determination. Simply contact your local FCRC or if you live in Chicago you can call Medical Field Operations at 312-793-8000.

You may give your home, car, and household furnishings to your community spouse or to someone else for the sole benefit of your community spouse. Depending on the resources your community spouse already has, you may give your community spouse resources valued up to $109,560. This resource amount may increase each year. Your local FCRC can tell you the actual amount you may give to your community spouse.

When your caseworker decides the amount of income you have to apply to the cost of your medical care, deductions are permitted if you give money to your spouse and any other dependent family members.

Dependent family members must live with your spouse. They include dependent children under age 21, dependent adult children, dependent parents or dependent brothers or sisters of either you or your community spouse.

Depending on your circumstances. You may give up to $2,739 of your income per month to your community spouse. You may also give up to $607 per month to each dependent family member. These income amounts may increase each year. Your local FCRC can tell you the actual amounts you may give.

A resources transfer occurs when you or your spouse (regardless of who has an interest in the resources) buys, sells, gives away or changes the way resources are held. This includes transferring ownership of the resources while retaining a life estate and when the life estate is liquidated. Also, a transfer occurs when an action is taken that causes resources not to be received (for example waiving the right to receive an inheritance).

A resources transfer may affect your eligibility. If you or your spouse have transferred resources for less than their worth, other than described in this form, you may be subject to a penalty period for CCP services through DoA, for nursing home services, and for supportive living facility services. If otherwise eligible, you remain entitled to other covered medical services. Transfers that may affect your eligibility are those made within 60 months of the date:

• of your application for medical coverage, or

• you apply for/receive in-home care services through DoA.

If the local FCRC decides that you are subject to a penalty period, the penalty begins with the month of the application and continues for as long as the uncompensated value of the transferred resources would meet the monthly cost of nursing care at the private rate. However, if a transfer is made during a penalty period and the local FCRC decides that you are subject to an additional penalty period, the penalty begins with the month following the month the previous penalty period ends. If you receive medical assistance, your FCRC caseworker will inform you of the penalty period.

You can get the most current income and resources information from your local FCRC.

HFS 2538A (R-01-15)