Data provided by the IRS match does not include the amount of money an applicant has in his or her financial accounts. The IRS provides data about the interest income on IRS Form 1099-INT, or dividends and distributions on IRS Form 1099-DIV earned by the applicant’s financial accounts, but does not provide the account balance. Based on the interest reported for the account, the subsidy determination system computes an estimated account balance for the applicant’s financial accounts. The system uses this estimated account balance as the agency data for financial accounts.

If you make contact with someone other than the potentially eligible applicant, use caution to avoid improper disclosure.

Follow the general verification procedure for contacting the applicant including phone contacts and sending the Evidence or Information Request Notice in HI 03035.006.

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  Ask if the applicant received the $250 one-time economic recovery payment under the ARRA.

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  For purposes of this exclusion, assume that the applicant retained the $250 payment. It is not necessary to ask the applicant if he or she retained these funds.

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  Exclude the $250 payment from resource counting for the month the applicant received the payment and for the following nine months when determining Part D Extra Help eligibility.

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  Correct the resource amounts on the resource verification screen if the applicant incorrectly reported any of these funds as resources and document the verification on the MAPS Report of Contact screen (DWRC).

EXAMPLE: If the applicant receives the one-time payment in May 2009, it does not count as a resource in the month of receipt and is excluded as a resource for June 2009 through February 2010. Count retained funds as countable resources beginning March 2010.

See Also:

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  HI 03030.020, For information on the resource exclusion for the one-time $250 payment

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  HI 03020.050, For more information on the income exclusion for the one-time $250 payment

The Making Work Pay Tax Credit provides for a tax credit of up to $400 per year for the years 2009 and 2010 (up to $800 per year for filers of joint tax returns).

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  During verification, if the applicant’s resources exceed the lower or higher resource limits for Medicare Part D Extra Help and the applicant reported wages on the application, develop the resource exclusion for this tax credit.

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  This tax credit increases the take home pay of working applicants because the employer reduces the rate of income tax withholding deducted from the applicant’s paycheck.

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  Do not count the increase in take home pay due to this tax credit as a resource in the month received and exclude it from resources for the following two months.

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  It is not feasible to determine the actual amount an applicant receives each month from this tax credit. For purposes of determining the excludable resource amount for the Medicare Part D Extra Help, we assume that the applicant receives a $35 per month excludable tax credit for any month that he or she receives wages. Assume that the excludable tax credit is $70 per month for a married couple for any month that both members of the couple receive wages.

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  If the applicant has more than one employer, assume that the tax credit is $35 per employer. For example, if the applicant has two jobs and the spouse has one job, the excludable amount would be $105 per month (3 times $35).

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  For purposes of applying this resource exclusion, assume that we retain the tax credit when making the resource determination. Assume that the applicant receives a tax credit in every month, he or she alleges wages on the application, and there is no allegation of a stop work date.

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  Applicants who have very low wages may not receive their full tax credit through an increase in their take home pay.

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  Self-employed applicants also do not receive the tax credit in take home pay. These applicants can get the tax credit as part of their tax refund when they file their income tax return. If the applicant receives a tax credit in their tax refund, exclude it from resources for the month of receipt and the following two months. In these situations, ask the applicant the amount received from the tax credit and exclude that amount.

  NOTE: 

  If the applicant also received the $250 one-time economic recovery payment, we reduce the Making Work Pay Tax Credit by that amount. Thus, if the applicant is eligible for the full $400 tax credit in his or her tax refund, the $400 tax credit is $150 ($400 minus $250).

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  Document the tax credit exclusion, determination on the MAPS Report of Contact screen (DWRC).

EXAMPLE: Tax credit received in take home pay

An applicant files for Medicare Part D Extra Help in June 2009. The application indicates that the applicant's spouse is working and there is no work stop date on the application. During verification, the claims specialist (CS) determines that the married couple's resources are over the resource limit and develops the resource exclusion for the Making Work Pay Tax Credit. The CS determines that $105 is excludable from resources ($35 per month for April, May, and June 2009) due to the wages of the applicant's spouse . The CS does an input to correct the amount of the married couple's resources and documents the verification contact and determination on the MAPS Report of Contact screen.

EXAMPLE: Tax credit received in tax refund

A beneficiary, receives Title II benefits, is self-employed, and files for Medicare Part D Extra Help in June 2010. During verification, the CS determines the beneficiary's resources are over the resource limit. The beneficiary received the Making Work Pay Tax credit in their tax refund because the beneficiary is self-employed. Because the beneficiary also received the $250 economic recovery payment in 2009, the Making Work Pay Tax Credit was reduced by $250. Based on the beneficiary's 2009 federal income tax return, the beneficiary received a $150 Making Work Pay Tax Credit as part of their tax refund in April 2010. This $150 tax credit is not countable as a resource in April 2010, and excluded from resources for May and June 2010.

ARRA establishes the Filipino Veterans Equity Compensation Fund that provides a one-time payment for veterans who served in the Philippines armed forces during World War II. Only a small number of veterans receive this one-time payment, however, some veterans who file for Medicare Part D Extra Help may require verification.

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  The veterans who are citizens of the United States are eligible for a one-time payment of $15,000. The veterans who are non-citizens are eligible for a one-time payment of $9,000. A veteran’s surviving spouse may receive this payment, but only if the veteran filed for it prior to death.

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  Exclude this one-time payment from resources to determine Medicare Part D Extra Help eligibility whether received by the veteran or the surviving spouse.

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  ARRA does not have a time limit on the resource exclusion for this payment. Therefore, exclude these funds for as long as we retain them.

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  Accept the applicant’s allegation about the amount of excluded funds retained from this special payment and exclude that amount.

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  If the applicant is unable to provide an allegation about the amount of retained funds from the special payment, develop the excluded amount using the instructions for commingled funds in, SI 01130.700.

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  Correct the resource amount on the resource verification screen if the funds are incorrectly reported as a resource and document the verification on the MAPS Report of Contact screen (DWRC).

See Also:

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  HI 03030.020, For more information about resource exclusions for Medicare Part D Extra Help

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  HI 03020.050, For more information about income exclusions for Medicare Part D Extra Help

When verifying resources for Extra Help applications filed May 1, 2008, through March 31, 2009, ask the applicant if he or she reported on the application any money received under the Economic Stimulus Act of 2008.

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  If yes, ask the applicant to provide the month the stimulus payment was received and determine if the funds are excludable. Do not count these funds as a resource for two months following the month of receipt when determining Medicare Part D Extra Help eligibility.

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  If the applicant incorrectly reports any of these funds as resources, the CR must correct the resource amounts on the resource verification screen accordingly. We always count conserved stimulus funds retained after March 2009 as resources because we assume that applicants received payments issued in December 2008 no later than January 2009.

For information about Extra Help income verification for stimulus payments, see HI 03035.010.

EXAMPLE: If the applicant receives a payment in May 2008, exclude the payment from resources for June 2008 and July 2008. In this example, the funds, if retained, are countable as a resource starting in August 2008.

Always accept the applicant’s allegation of the amount of cash.

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  Accept the applicant’s allegation without further development, if the agency data indicates ownership of savings bonds and the applicant denies ownership. Process the application based on the applicant’s allegation.

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  Document when we receive saving bond data from the Bureau of Public Debt (BPD) and adjudicate the application using the applicant’s allegations on the MAPS Report of Contact screen.

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  Do not contact the Bureau of Public Debt or the Parkersburg, WV field office to verify ownership of U.S. savings bonds.

The total dollar amount for agency data in the “Bank Accounts Balance” field and the “Stocks and Bonds Balance” field does not reflect the actual source of the agency data.

The Medicare System Query displays available fields from the Medicare database. This query contains information about the source of the agency data for those two fields.

Use the Medicare System Query for information about the data the agency uses, by clicking on the Query option on the verification screen.

For documentation requirements, see HI 03035.007. Use the MAPS verification screens to document:

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  Verified balance amounts: verified balance amounts for the “Bank Accounts Balance” field and the “Stocks and Bonds Balance” fields;

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  Contacts: the dates and types of contacts made;

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  Evidence: the types of evidence requested and reviewed; and

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  Determination: the CS’ determination of “resolved” or “failure to cooperate.”

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  Use the “Resources” section of the verification screen to input the correct amounts for resources.

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  Select “None,” “Application,” “Agency,” or “New Amount” to indicate the correct amount of resources for the applicant.

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  When you resolve resource issues, go to the “Issue Resolution” section and select “Resolved” and “Submit to Subsidy Determination.”

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  If attempts to contact the applicant were not successful and the applicant does not respond to the Evidence Request Notice within the closeout period, select “Failure to Cooperate” and “Submit to Subsidy Determination.”