1. Which of the following is considered a countable asset for Medicaid
eligibility purposes?
A. Primary residence
B. One vehicle used for transportation
C. Cash in a savings account
D. Burial plot
Answer: C
Explanation: Cash in a savings account is a liquid, countable resource; the
home, one car, and burial plot are exempt under most state rules.
2. The federal law governing Medicaid is contained primarily in which Title of
the Social Security Act?
A. Title IV
B. Title XIX
C. Title XXI
D. Title XVIII
Answer: B
Explanation: Medicaid is established under Title XIX of the Social Security
Act (1965).
3. The “look-back period” for Medicaid asset transfers is generally:
A. 12 months
B. 24 months
C. 36 months
D. 60 months
Answer: D
Explanation: The Deficit Reduction Act of 2005 standardized a 60-month (5-
year) look-back period for most transfers.
,4. Which of the following is an exempt transfer for Medicaid eligibility?
A. Gift to an adult child
B. Transfer to a disabled child
C. Gift to a friend
D. Donation to charity
Answer: B
Explanation: Transfers to or for the benefit of a disabled child are exempt
under Medicaid rules.
5. The term “community spouse” refers to:
A. A spouse living in a nursing home
B. A spouse remaining in the community
C. A divorced spouse
D. A disabled spouse
Answer: B
Explanation: The community spouse is the one who remains in the
community while the other receives institutional care.
6. The Community Spouse Resource Allowance (CSRA) is designed to:
A. Allow both spouses to share equally in all income
B. Protect a portion of the couple’s assets for the community spouse
C. Eliminate income testing
D. Allow the institutionalized spouse to keep all assets
Answer: B
Explanation: The CSRA protects a portion of marital assets for the community
spouse to prevent impoverishment.
7. Which of the following income sources is typically countable for Medicaid
eligibility?
A. VA Aid and Attendance
B. SSI payments
C. Pension income
D. SNAP benefits
Answer: C
Explanation: Pension income is countable; SSI, SNAP, and certain VA
benefits are excluded.
,8. The penalty period for transferring assets below fair market value is
calculated by dividing the:
A. Transferred amount by the regional average private-pay nursing home rate
B. Total income by the state minimum wage
C. Home equity by average daily rate
D. Transferred amount by the applicant’s income
Answer: A
Explanation: The penalty is based on the value transferred ÷ average
monthly nursing home cost in that state/region.
9. Which of the following is a trust commonly used in Medicaid planning?
A. Revocable living trust
B. Qualified Income Trust (Miller Trust)
C. Roth IRA
D. Testamentary trust
Answer: B
Explanation: A Miller Trust is used in “income cap” states to meet Medicaid
income limits.
10. The “Medicaid applicant” is:
A. Always the community spouse
B. The individual seeking Medicaid benefits
C. The attorney assisting with planning
D. The state caseworker
Answer: B
Explanation: The applicant is the person applying for benefits under Title
XIX.
11. A Medicaid-compliant annuity must be:
A. Irrevocable and non-assignable
B. Revocable
C. Payable to any heir
D. Based on joint life expectancy
Answer: A
Explanation: Medicaid-compliant annuities must be irrevocable, non-
assignable, actuarially sound, and name the state as remainder beneficiary.
, 12. Which of the following is true about Medicaid’s “income-first” rule?
A. It applies only to children
B. It requires income to be considered before assets are shifted
C. It applies only to veterans
D. It is used to calculate asset transfer penalties
Answer: B
Explanation: The income-first rule requires states to first allocate income to
meet spousal needs before allowing asset transfers.
13. Medicaid is jointly funded by:
A. States only
B. Federal and state governments
C. Federal only
D. Local counties
Answer: B
Explanation: Medicaid is a joint federal–state program with each state
administering its plan under federal guidelines.
14. Which of the following describes “spend-down”?
A. The process of increasing assets
B. Reducing income to qualify for Medicaid
C. Reducing countable assets to meet eligibility limits
D. Increasing the CSRA
Answer: C
Explanation: A spend-down involves reducing assets (e.g., paying debts,
home repairs) to meet Medicaid limits.
15. The Deficit Reduction Act of 2005 primarily affected Medicaid planning by:
A. Shortening the look-back period
B. Lengthening the look-back period and delaying penalty start dates
C. Eliminating annuities
D. Increasing income limits
Answer: B
Explanation: The DRA extended the look-back to 60 months and delayed the
penalty start date until institutionalization.
eligibility purposes?
A. Primary residence
B. One vehicle used for transportation
C. Cash in a savings account
D. Burial plot
Answer: C
Explanation: Cash in a savings account is a liquid, countable resource; the
home, one car, and burial plot are exempt under most state rules.
2. The federal law governing Medicaid is contained primarily in which Title of
the Social Security Act?
A. Title IV
B. Title XIX
C. Title XXI
D. Title XVIII
Answer: B
Explanation: Medicaid is established under Title XIX of the Social Security
Act (1965).
3. The “look-back period” for Medicaid asset transfers is generally:
A. 12 months
B. 24 months
C. 36 months
D. 60 months
Answer: D
Explanation: The Deficit Reduction Act of 2005 standardized a 60-month (5-
year) look-back period for most transfers.
,4. Which of the following is an exempt transfer for Medicaid eligibility?
A. Gift to an adult child
B. Transfer to a disabled child
C. Gift to a friend
D. Donation to charity
Answer: B
Explanation: Transfers to or for the benefit of a disabled child are exempt
under Medicaid rules.
5. The term “community spouse” refers to:
A. A spouse living in a nursing home
B. A spouse remaining in the community
C. A divorced spouse
D. A disabled spouse
Answer: B
Explanation: The community spouse is the one who remains in the
community while the other receives institutional care.
6. The Community Spouse Resource Allowance (CSRA) is designed to:
A. Allow both spouses to share equally in all income
B. Protect a portion of the couple’s assets for the community spouse
C. Eliminate income testing
D. Allow the institutionalized spouse to keep all assets
Answer: B
Explanation: The CSRA protects a portion of marital assets for the community
spouse to prevent impoverishment.
7. Which of the following income sources is typically countable for Medicaid
eligibility?
A. VA Aid and Attendance
B. SSI payments
C. Pension income
D. SNAP benefits
Answer: C
Explanation: Pension income is countable; SSI, SNAP, and certain VA
benefits are excluded.
,8. The penalty period for transferring assets below fair market value is
calculated by dividing the:
A. Transferred amount by the regional average private-pay nursing home rate
B. Total income by the state minimum wage
C. Home equity by average daily rate
D. Transferred amount by the applicant’s income
Answer: A
Explanation: The penalty is based on the value transferred ÷ average
monthly nursing home cost in that state/region.
9. Which of the following is a trust commonly used in Medicaid planning?
A. Revocable living trust
B. Qualified Income Trust (Miller Trust)
C. Roth IRA
D. Testamentary trust
Answer: B
Explanation: A Miller Trust is used in “income cap” states to meet Medicaid
income limits.
10. The “Medicaid applicant” is:
A. Always the community spouse
B. The individual seeking Medicaid benefits
C. The attorney assisting with planning
D. The state caseworker
Answer: B
Explanation: The applicant is the person applying for benefits under Title
XIX.
11. A Medicaid-compliant annuity must be:
A. Irrevocable and non-assignable
B. Revocable
C. Payable to any heir
D. Based on joint life expectancy
Answer: A
Explanation: Medicaid-compliant annuities must be irrevocable, non-
assignable, actuarially sound, and name the state as remainder beneficiary.
, 12. Which of the following is true about Medicaid’s “income-first” rule?
A. It applies only to children
B. It requires income to be considered before assets are shifted
C. It applies only to veterans
D. It is used to calculate asset transfer penalties
Answer: B
Explanation: The income-first rule requires states to first allocate income to
meet spousal needs before allowing asset transfers.
13. Medicaid is jointly funded by:
A. States only
B. Federal and state governments
C. Federal only
D. Local counties
Answer: B
Explanation: Medicaid is a joint federal–state program with each state
administering its plan under federal guidelines.
14. Which of the following describes “spend-down”?
A. The process of increasing assets
B. Reducing income to qualify for Medicaid
C. Reducing countable assets to meet eligibility limits
D. Increasing the CSRA
Answer: C
Explanation: A spend-down involves reducing assets (e.g., paying debts,
home repairs) to meet Medicaid limits.
15. The Deficit Reduction Act of 2005 primarily affected Medicaid planning by:
A. Shortening the look-back period
B. Lengthening the look-back period and delaying penalty start dates
C. Eliminating annuities
D. Increasing income limits
Answer: B
Explanation: The DRA extended the look-back to 60 months and delayed the
penalty start date until institutionalization.
