N.M. Admin. Code § 8.281.500.7

Current through Register Vol. 35, No. 20, October 22, 2024

Section 8.281.500.7 - DEFINITIONS

A.Definitions beginning with "A":

(1)Actuarially sound: With respect to an annuity or promissory note, the payments made to the beneficiary must not exceed their life expectancy and returns to the beneficiary an amount at least equal to the amount used to establish the contract.

(2)Annuity: A financial instrument, usually sold by a life insurance company, that pays out a regular income at fixed intervals for a certain period of time, often beginning at a certain age and continuing for the life of the owner.

(3)Asset limit: An applicant or recipient may be eligible for a MAP category of institutional care on the factor of resources if countable resources do not exceed $2,000.

(4)Assets: All income and resources of an applicant or recipient and their spouse, if applicable.

(5)Authorized representative: The individual designated to represent and act on the applicant's or recipient's behalf during the eligibility process. The applicant or recipient or their authorized representative must provide formal documentation authorizing the named individual or individuals to access the identified case information for a specified purpose and time frame. An authorized representative may be an attorney representing a person or household, a person acting under the authority of a valid power of attorney, a guardian, or any other individual or individuals designated in writing by the claimant.

B.Definitions beginning with "B": Bona fide: A bona fide agreement is made in good faith and is legally valid.

C.Definitions beginning with "C":

(1)Community spouse: The spouse of an institutionalized applicant or eligible recipient who is residing in the community and is not in an institution.

(2)Community spouse resource allowance (CSRA): An amount of a married couple's resources that is set aside for the community spouse when the eligible recipient is institutionalized. There is a MAD minimum and a federal maximum amount of resources that can be set aside for the community spouse.

D.Definitions beginning with "D": [RESERVED]

(2)Institutionalized spouse: An applicant or recipient who is in an acute care hospital, nursing facility, intermediate care facility for individuals with intellectual disabilities (ICF-IID), swing bed or certified in-state inpatient rehabilitation center.

E.Definitions beginning with "E": Encumbrance: A general term for any claim or lien on a parcel of real property, including mortgages, deeds of trust and abstracts of judgments.

F.Definitions beginning with "F": Fair market value: An estimate of the value of an asset, if sold at the prevailing price at the time it was actually transferred. Value is based on criteria used in appraising the value of assets for the purpose of determining a MAP category of eligibility.

G.Definitions beginning with "G": [RESERVED]

H.Definitions beginning with "H": Home equity: (Also known as equity value.) The value of a home minus the total amount owed on it in mortgages, liens and other encumbrances.

I.Definitions beginning with "I":

(1)Income: Anything that an applicant or recipient receives in cash or in kind that [he or she] they can use to meet their needs for food and shelter. In-kind income is not cash, but is actual food or shelter, or something that the applicant or recipient can use to get one of these.

J.Definitions beginning with "J": [RESERVED]

K.Definitions beginning with "K": [RESERVED]

L.Definitions beginning with "L":

(1)Life estate: An interest in property that exists for the life of a person. For example, an individual gives a life estate in a house to person A and the remainder to person B. Person A has a life estate and person B has a remainder interest until person A dies.

(2)Liquid resource: Cash or something that can easily be converted to cash within 20 business days.

(3)Loan: A transaction in which one party advances money to, or on behalf of another party, who promises to repay the lender in full, with or without interest.

(4)Long-term Care Insurance Policy: A type of insurance developed specifically to cover the costs of nursing homes, assisted living, home health care and other long-term care services as specified in the individual's policy.

(5)Lookback period: A period of time in the past through which the ISD caseworker may examine all financial transactions for asset transfers.

M.Definitions beginning with "M": Minimum monthly maintenance needs allowance: A minimum level of income that the federal government allows to be set aside for the support of the community spouse when the other spouse is in an institution.

N.Definitions beginning with "N": [RESERVED]

(1)Negotiable agreement: An agreement (i.e., a loan) in which the ownership of the agreement and the whole amount of money can be transferred from one person to another.

(2)Non-liquid resource: An asset such as real property, which cannot be easily converted to cash within 20 days.

O.Definitions beginning with "O": [RESERVED]

P.Definitions beginning with "P":

(1)Promissory note: A promissory note is a written, unconditional agreement in which one person promises to pay a specified sum of money at a specified time to another person.

(2)Protected Asset Limit: Protected assets up to the amount of qualified long-term care insurance partnership (QLTCPI) benefit payments made to or on the behalf of individual. This is the applicant's or recipient's protected asset limit (PAL).

Q.Definitions beginning with "Q": Qualified state long-term care insurance partnership (QSLTCIP) program: A partnership program that joins MAD with private insurance companies that offer long-term care insurance policies. The MAP eligibility requirements are adjusted to provide financial incentives for eligible recipients to purchase private QSLTCIP coverage.

R.Definitions beginning with "R":

(1)Relative: Relative is defined as a spouse, son or daughter; grandson or granddaughter; step-son or step-daughter; in-laws; mother or father; step-mother or step-father; half-sister or half-brother; grandmother or grandfather; aunt or uncle; sister or brother; step-brother or step-sister; and niece or nephew.

(2)Remainder/remainder man: An interest in property that occurs after a life estate. For example, an individual gives a life estate in a house to person A and the remainder to person B. Person A has a life estate and Person B has a remainder interest until person A dies. Person B is also called the remainderman.

(3)Resources: Cash or other liquid assets and any real or personal property that applicant or recipient (or spouse if any) owns and could convert to be used for their support and maintenance.

(4)Restricted coverage: An eligible recipient who has restricted coverage may access medically necessary MAD benefits except for long-term care services in a nursing facility.

(5)Reverse mortgage: A loan against home equity providing cash advances to a borrower and requiring no repayment until a future date.

S.Definitions beginning with "S":

(1)Sole benefit of: A transfer is considered for the sole benefit of a spouse, blind or disabled child, or a disabled individual if the transfer is arranged in such a way that no individual or entity except the spouse, blind, or disabled child, or disabled individual can benefit from the assets transferred in any way, whether at the time of the transfer or at any time in the future.

(2)Spouse: For purposes of this rule, a spouse is an individual who is legally married under the laws of a state, a territory, or a foreign jurisdiction in which the marriage was celebrated.

T.Definitions beginning with "T": Transfer: To change over the possession, control or ownership of something.

U.Definitions beginning with "U": [RESERVED]

V.Definitions beginning with "V": [RESERVED]

W.Definitions beginning with "W": [RESERVED]

X.Definitions beginning with "X": [RESERVED]

Y.Definitions beginning with "Y": [RESERVED]

Z.Definitions beginning with "Z": [RESERVED]

N.M. Admin. Code § 8.281.500.7

8.281.500.7 NMAC - N, 4-1-09; A, 10-1-12, Adopted by New Mexico Register, Volume XXVI, Issue 15, August 14, 2015, eff. 8/15/2015, Amended by New Mexico Register, Volume XXIX, Issue 04, February 27, 2018, eff. 3/1/2018, Amended by New Mexico Register, Volume XXXIII, Issue 22, November 29, 2022, eff. 12/1/2022