Resources overview

Revised date
Purpose statement

To explain how resources affect eligibility for SSI-Related Apple Health programs.

WAC 182-512-0300 SSI-related medical -- Resources eligibility.

WAC 182-512-0300 SSI-related medical -- Resources eligibility.

Effective January 27, 2019

  1. At 12:00 a.m. on the first day of the month a client's countable resources must be at or below the resource standard to be eligible for noninstitutional medical benefits for that month. If the total of the client's countable resources is above the resource standard at 12:00 a.m. on the first day of the month, the client is ineligible for noninstitutional medical benefits for that entire month regardless of resource status at the time of application during that month. For resource eligibility relating to long term care eligibility see chapter 182-513 WAC.
  2. An excluded resource converted to another excluded resource remains excluded.
  3. Cash received from the sale of an excluded resource becomes a countable resource the first of the month following conversion unless the cash is:
    1. Used to replace the excluded resource;
    2. Invested in another excluded resource in the same month or within the longer time allowed for home sales under WAC 182-512-0350; or
    3. Spent.
  4. The unspent portion of a nonrecurring lump sum payment is counted as a resource on the first of the month following its receipt with the following exception: the unspent portion of any Title II (SSA) or Title XVI (SSI) retroactive payment is excluded as a resource for nine months following the month of receipt. These exclusions apply to lump sums received by the client, client's spouse or any other person who is financially responsible for the client.
  5. Clients applying for SSI related medical coverage for long term care (LTC) services must meet different resource rules. See chapter 182-513 WAC for LTC rules.
  6. The transfer of a resource without adequate consideration does not affect medical program eligibility except for LTC services described in chapters 182-513 and 182-515 WAC. In those programs, the transfer may make a client ineligible for medical benefits for a period of time. See WAC 182-513-1363 for LTC rules.

This is a reprint of the official rule as published by the Office of the Code Reviser. If there are previous versions of this rule, they can be found using the Legislative Search page.

Worker responsibilities

  1. Follow these steps for medical assistance units (MAU) with resources:
    1. Determine whether the MAU owns resources, and whether they are available. See Resource ownership and availability.
    2. Separate the excluded from the countable resources. See Resources exclusions.
    3. Add the values of all countable resources. Follow instructions in the Asset verification system section of the manual for bank and credit union accounts.
    4. Compare the total countable resources to the appropriate limit.
    5. Set tickle in Barcode to review unavailable resources that might become available.
  2. When an MAU reports receipt of a resource that exceeds the applicable resource limit (by itself or in addition to other countable resources):
    1. Send 10-day letter requesting verification of the resources the individual claims they own and current value.
    2. Stop coverage when the MAU fails to verify its declared resources or its resources exceed the applicable resource limit. See WAC 182-518-0025.
  3. When a recipient converts a resource to a new type:
    1. Send 10-day letter requesting verification of the resources the individual claims they own and its current value.
    2. Determine whether the new resource is excluded or countable.
    3. If the total of all countable resources is over the limit, stop coverage and provide the MAU with advance and adequate notice. See WAC 182-518-0025.
  4. For regular SSI-related Medicaid, do not request verification of resources when no resources are listed on the application or review form. If you have requested verification when none are listed by the client, do not deny benefits based on no response to this kind of request.

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