<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".08-4" citation="COMAR 10.09.24.08-4" title_num="10" subtitle_num="09" chapter_num="24" heading="Resource Consideration of Long-Term Care Partnership Policies.">
  <paragraph num="A.">
    <text>This regulation establishes the rules for applicants and recipients who:</text>
    <paragraph num="(1)">
      <text>Own a long-term care (LTC) partnership policy; and</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Meet all factors of Medicaid eligibility in accordance with MAGI Exempt coverage groups described in this chapter.</text>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>Definitions.</text>
    <paragraph num="(1)">
      <text>In this regulation, the following terms have the meanings indicated.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Defined Terms.</text>
      <paragraph num="(a)">
        <text>“Benefit payment amount” means the dollar value of LTC benefits which an insurance carrier has furnished on behalf of a partnership policyholder and which is disregarded from the resource amount when determining eligibility.</text>
      </paragraph>
      <paragraph num="(b)">
        <text>“Insurance carrier” means an insurer who issues an insurance policy and makes benefit payment amounts on behalf of a partnership policyholder.</text>
      </paragraph>
      <paragraph num="(c)">
        <text>“Partnership policy” means a LTC insurance policy that meets the requirements as described under COMAR 31.14.03.02 and whose benefit payment amount is disregarded from the resource amount when determining eligibility.</text>
      </paragraph>
      <paragraph num="(d)">
        <text>“Partnership policyholder” means an individual who owns a partnership policy under the federal LTC partnership program.</text>
      </paragraph>
      <paragraph num="(e)">
        <text>“Reciprocity compact” means an agreement among states having partnership programs that are approved under section 6021(b) of the Deficit Reduction Act of 2005, Public Law 109-171 (DRA).</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>Partnership Policyholder Requirements.</text>
    <paragraph num="(1)">
      <text>An applicant or recipient shall meet all factors of Medicaid eligibility in accordance with rules for MAGI Exempt coverage groups set forth in this chapter.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>An applicant or recipient shall have:</text>
      <paragraph num="(a)">
        <text>A Maryland partnership policy approved on or after January 1, 2009, that meets all certification requirements, as described in COMAR 31.14.03; or</text>
      </paragraph>
      <paragraph num="(b)">
        <text>A partnership policy approved in another state that has joined the national reciprocity compact under the federal LTC partnership program.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(3)">
      <text>An applicant or recipient shall provide documentation of the partnership policy benefit payments that have been issued by an insurance carrier.</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Subject to Regulation .10-2E of this chapter, an applicant or recipient who applies for LTC Medical Assistance in a nursing facility or through a waiver program shall be ineligible for payment for nursing facility services, or services under a home and community based waiver program, when the individual’s equity interest in home property exceeds the maximum allowable home equity amount as set forth in Regulation .10-2 of this chapter.</text>
    </paragraph>
  </paragraph>
  <paragraph num="D.">
    <text>Eligibility Determination for a Partnership Policyholder.</text>
    <paragraph num="(1)">
      <text>When determining the resources of an individual in accordance with Regulation .08 of this chapter, there shall be disregarded a dollar value equal to the benefit payment amount.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>The benefit payment amount for purposes of the disregard set forth in §D(1) of this regulation shall:</text>
      <paragraph num="(a)">
        <text>For purposes of initial application, equal the dollar amount of benefits paid to or on behalf of the partnership beneficiary at the time of application; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>For purposes of redetermination, equal the benefit payment amount in §D(2)(a) of this regulation and the value of any additional benefits paid to or on behalf of the partnership beneficiary up to the time of redetermination, until all benefits under the partnership policy are exhausted.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(3)">
      <text>At the time of application and at each redetermination, the Department shall request documentation of the benefit payment amount.</text>
    </paragraph>
  </paragraph>
  <paragraph num="E.">
    <text>With the exception of an amount equal in value to the benefit payment amount applied at the most recent redetermination period, partnership policyholders will continue to be subject to a penalty for asset transfers for less than fair market value in accordance with Regulation .08 of this chapter.</text>
  </paragraph>
  <paragraph num="F.">
    <text>Estate recovery by the Department is limited as set forth in Regulation .15A-3(5) of this chapter.</text>
  </paragraph>
</regulation>