G   Death

Policy

1)    Death of a Customer

When a customer dies his or her eligibility is stopped.  When there are other people in the budget group receiving AHCCCS Medical Assistance (MA), the eligibility of these customers must be reviewed as a change in household size (MA1502N).

An ALTCS customer may receive a Share of Cost (SOC) adjustment for the month he or she died.  To determine if a SOC adjustment is needed, the prorated capitation rate is compared to the SOC for the month.  The SOC for the month the customer died is the prorated capitation rate or the customer’s monthly SOC, whichever is lower.

NOTE    ALTCS customers who receive Fee-For-Service coverage (MA1103) do not receive a Share of Cost adjustment.

See Prorating Share of Cost When a Customer Dies Examples

2)    Death of a Spouse

The death of a customer’s spouse results in a change in the customer’s marital status and may affect the customer’s:

·        Income eligibility;

·        ALTCS SOC;

·        ALTCS resource eligibility; or

·        ALTCS transfer penalty, if any.

When the customer is eligible for ALTCS, use of community spouse policy stops the month after the month the customer’s spouse died.

The customer’s counted income may be less when the deceased spouse was part of the customer’s budget group and had income.  However, the customer may get more income or resources due to the spouse’s death as described below:

·        The customer may get increased Social Security (SSA) benefits, all or a portion of the spouse’s pension, or Veteran’s Administration (VA) benefits.

·        The customer may be the beneficiary of death benefits or entitled to assets from the deceased person.

3)    Death of a Parent or Other Household Member

The death of a parent or other household member may affect the customer’s:

·        Income eligibility;

·        ALTCS SOC; or

·        Resource eligibility (for ALTCS).

The customer’s counted income may be less when the deceased person was part of the customer’s budget group and had income.  However, the customer’s income could increase due to qualifying for a survivor’s benefit or inheriting income or resources due to the death.

Definitions

Proof

The following forms of verification are accepted as proof of date of death:

·        Collateral contact with knowledgeable sources such as relatives, case managers, hospital or nursing facility where the customer died, or the funeral home that handled the burial arrangements;

·        Social Security record showing date of death;

·        Obituary in a newspaper; or

·        Death records from Vital Records including:

o       Electronic reporting from the agency; or

o       An official death certificate.

NOTE    When records are available from Vital Records they are used over all other forms of proof. Any discrepancies  must be reported to Vital Records by a family member.  Only a family member can request a change to the death record.

Timeframes

The change must be reported within 10 calendar days of the date of death.

Legal Authority