CurrentIndiana Department of InsurancePolicy 4800

Burial Assistance

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This chapter governs eligibility, resource treatment, payment limits, claim handling, and contribution calculations for burial assistance under the Indiana Health Coverage Program.

Policy Summary

PayerIndiana Department of Insurance

PolicyBurial Assistance

Policy CodePolicy 4800

Change TypeNo material change

Effective DateN/A

Next Review DateN/A

Key ActionSubmit the signed claim form and all necessary supporting documentation to the FSSA office within 90 days of the date of death.

SourceLink

POLICY UPDATE CHANGES

No material clinical or coverage changes in this revision.

100%State funding

$1,200Funeral maximum

$800Cemetery maximum

$2,000Combined maximum

90 daysClaim deadline

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CurrentIndiana Department of InsurancePolicy 4800

Burial Assistance

Customize your policy alerts

Sign up for Indiana Department of Insurance Policy 4800 alerts

Get alerted when Policy 4800 changes without checking for updates manually.

Monitor payer policy activity

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This chapter governs eligibility, resource treatment, payment limits, claim handling, and contribution calculations for burial assistance under the Indiana Health Coverage Program.

Policy Summary

PayerIndiana Department of Insurance

PolicyBurial Assistance

Policy CodePolicy 4800

Change TypeNo material change

Effective DateN/A

Next Review DateN/A

Key ActionSubmit the signed claim form and all necessary supporting documentation to the FSSA office within 90 days of the date of death.

SourceLink

POLICY UPDATE CHANGES

No material clinical or coverage changes in this revision.

100%State funding

$1,200Funeral maximum

$800Cemetery maximum

$2,000Combined maximum

90 daysClaim deadline

Cemetery denial threshold

Burial Assistance Eligibility and Payment Rules

Recipient Eligibility

Burial Assistance is available when ALL of the following recipient eligibility criteria are met:

ALL of the following

The individual was receiving Medicaid in an eligible Aged, Blind, or Disabled category at the time of death: MA A, MA B, MA D, MASI, MADW, or MA R.
Alternatively, the individual applied for Medicaid before death and was subsequently determined eligible for one of the eligible categories.
The individual died on or after July 1, 1999.
The individual is not enrolled in the Disability Improved (MADI) category or any other Medicaid category.

Eligibility is not affected by the location of death or by whether the funeral and interment occur in Indiana or elsewhere.

Burial Assistance is 100% state funded.

Funeral Director Payment

Funeral director payment is determined from eligible unpaid expenses, available contributions and deceased resources, and the statutory maximum.

ALL of the following

Eligible funeral director expenses include reasonable body preparation, including cremation; necessary clothing; a casket; funeral services; transportation of the body; and professional funeral director services.
All contributions from relatives or friends, payments from the deceased recipient's estate, and resources of the deceased must be considered.
The claim has unpaid eligible funeral director expenses.

The funeral director payment may not exceed $1,200, including sales tax, or the amount of unpaid eligible expenses, whichever is less.≤ $1,200

Cemetery Payment

Cemetery payment is available for eligible unpaid interment expenses after considering contributions and deceased resources.

ALL of the following

The expense is connected with interment of the body or remains in a cemetery, including necessary burial rights, opening and closing the burial plot, an outer container, or services required by cemetery authorities.
Cremated remains are buried in a cemetery; a cremation vault alone is not a cemetery expense.
A signed burial transit permit accompanies the cemetery expense claim.
The claim does not seek payment for a monument or headstone.
All contributions from relatives or friends, payments from the deceased recipient's estate, and resources of the deceased are considered.

Cemetery Payment Limits

The cemetery payment outcome is based on total contributions plus resources of the deceased.

ONE of

If contributions and deceased resources total $1,000 or less, pay up to $800 or the unpaid eligible cemetery expenses, whichever is less.
If contributions and deceased resources exceed $1,000 but are less than $1,800, reduce the $800 maximum dollar for dollar by the amount above $1,000; pay up to the reduced amount or unpaid eligible cemetery expenses, whichever is less.
If contributions and deceased resources total $1,800 or more, pay no cemetery expenses.

Burial Claim Submission

Burial claims must be filed with FSSA using the required form and documentation.

ALL of the following

The funeral director and cemetery representative file separate claims, except when a funeral director properly files a cemetery claim under the designated-representative procedure.
The claim uses State Form 35937, Medicaid Recipients Claim to Defray Burial Costs.
The signed claim form and all necessary supporting documentation are submitted to the FSSA office within 90 days after the date of death.≤ 90 days
Failure to submit all required documents within 90 days may result in denial.

When a funeral director files the cemetery claim

The funeral director attaches proof that they are a cemetery representative or have been designated by the cemetery representative.

FSSA Review, Approval, and Reimbursement

FSSA reviews available resources and contributions, certifies approved claims, and routes authorized payment to the claimant vendor.

ALL of the following

FSSA evaluates burial charges, other funds available to meet the expenses, and the legal maximum payments from public funds.
Any other resources identified are summarized, and amounts paid by all other sources are verified before a payment recommendation is made.
If resources are discovered after payment, reimbursement to FSSA is requested.
When FSSA determines that other payments are insufficient and approves the claim, the FSSA Authorized Designee certifies that State Form 35937 is properly completed and that the recommended amount is correct based on the submitted information.
The FSSA Authorized Designee signs the form, retains the original, and submits a copy to Accounts Payable.

Insurance Settlement Treatment

Insurance settlements are treated according to who receives the settlement and how the funds are used.

ALL of the following

A surviving relative may be the beneficiary of a cash settlement from a life insurance policy on the deceased recipient.
The insurance settlement is income or a resource of the surviving relative.
Any portion of the settlement used for the deceased recipient's burial expenses is treated as a contribution from a relative and is included in burial payment calculations.
If the surviving relative is also an applicant or recipient, the settlement may affect eligibility depending on the applicable program.

Program Categories, Forms, and Payment Thresholds

Required state claim and vendor formsmixed

State Form 35937	Medicaid Recipients Claim to Defray Burial Costs
State Form 53788	Request for Taxpayer Identification Number and Certification; vendor information and W-9 form

Programs whose deceased recipients may qualify for burial expense payment considerationmixedCovered

MA A	Medicaid for the Aged
MA B	Medicaid for the Blind
MA D	Medicaid for the Disabled
MASI	Medicaid assistance category identified in the burial payment provision
MADW	Medicaid Disabled Working
MA R	Residential Care Assistance Program

Eligible Medicaid categories

Eligible categoriesMA A, MA B, MA D, MASI, MADW, or MA R

Program scopeMedicaid Aged, Blind, and Disabled categories

Eligibility timingThe individual was receiving Medicaid at death or applied before death and was later determined eligible for an eligible category

Excluded Medicaid category

Excluded categoryMADI

Category descriptionDisability Improved

Payment status

Claim Preparation, Documentation, and Payment Actions

Billing Rule

Apply deceased resources to burial expenses

The funeral director and/or cemetery representative must obtain available resources of the deceased, such as a burial trust, bank account, or personal funds remaining in a nursing home, as payment for burial expenses in accordance with the Indiana Probate Code.

Documentation Required

Limit funeral expenses to eligible services

Claim only reasonable funeral director expenses connected with preparation of the body, cremation, necessary clothing, a casket, funeral services, transportation of the body, and professional funeral director services.

Payment remains subject to the applicable maximum and unpaid eligible expenses.

Burial Assistance Terms

Estate of the deceased

ContentsAll real and personal property owned by the deceased recipient

Formal proceedingsNot required to establish the estate

ValuationFSSA may establish the estate's value and determine the total amount payable for burial expenses

Resources of the deceased

Included resourcesA burial trust, bank account, or personal funds remaining on account in a nursing home

Required useResources shall be used to meet burial expenses

Required action

Policy Summary

PayerIndiana Department of Insurance

PolicyBurial Assistance

Policy CodePolicy 4800

Change TypeNo material change

Effective DateN/A

Next Review DateN/A

Key ActionSubmit the signed claim form and all necessary supporting documentation to the FSSA office within 90 days of the date of death.

SourceLink

On This Page

An aggregate $2,500 exclusion applies to contributions and deceased resources. Amounts above $2,500 are subtracted from the $1,200 statutory maximum.

If contributions and deceased resources total $2,500 or less, payment is up to $1,200 or the unpaid eligible expenses, whichever is less.

If contributions and deceased resources exceed $2,500 but are less than $3,700, the $1,200 maximum is reduced dollar for dollar by the amount above $2,500; payment remains limited to the reduced amount or unpaid eligible expenses, whichever is less.

If contributions and deceased resources total $3,700 or more, no funeral director expenses are paid.

The claim has unpaid eligible cemetery expenses.

The cemetery payment may not exceed $800 or the amount of unpaid eligible expenses, whichever is less.≤ $800

A $1,000 exclusion applies to contributions and deceased resources. Amounts above $1,000 are subtracted from the $800 statutory maximum.

The funeral director attaches a signed receipt verifying that cemetery expenses have been paid.

If opening and closing the grave were provided without charge, the funeral director records that fact on the claim.

If the funeral director has been designated as the cemetery representative, a cemetery claim submitted by another party will not be paid.

Recommendations for funeral and cemetery expenses are submitted for final approval to the Medicaid Medical Review Team, Office of Medicaid Policy and Planning.

FSSA follows up on inaccurate contribution information. Collusion, misrepresentation, or apparent fraud intended to obtain additional payment may be referred for prosecution.

Contribution amounts must be accurately reported.

Vendor payment requirements

A business receiving payment from the State Auditor must have State Form 53788, Vendor Information Form/Request for Taxpayer Identification Number and Certification, on file with the State Auditor.
If the business has never received payment through the State Auditor, a completed State Form 53788 W-9 is attached to the initial claim.
Reimbursement is made directly to the claimant vendor by direct deposit to the account on file through the completed vendor information form.

Burial Assistance is not available to recipients in this category

Funeral director maximum

Maximum payment$1,200

IncludesSales tax

Payment limitationPayment is limited to unpaid eligible funeral director expenses

Cemetery maximum

Maximum payment$800

Applies toCemetery expenses

Payment limitationPayment is limited to unpaid eligible cemetery expenses

Combined burial assistance maximum

Combined maximum$2,000

Funeral director maximum$1,200

Cemetery maximum$800

Funeral contribution/resource exclusion

Excluded amount$2,500

Applies toContributions and resources used to calculate the funeral director payment

Effect above exclusionAmounts above $2,500 are subtracted from the $1,200 statutory maximum

Funeral no-payment threshold

No-payment threshold$3,700 or more

Calculation basisAll contributions plus the resources of the deceased

Payment resultNone of the funeral director's expenses will be paid

Cemetery contribution/resource exclusion

Excluded amount$1,000

Applies toContributions and resources used to calculate the cemetery payment

Effect above exclusionAmounts above $1,000 are subtracted from the $800 statutory maximum

Cemetery no-payment threshold

No-payment threshold$1,800 or more

Calculation basisAll contributions plus the resources of the deceased

Payment resultCemetery representative expenses will not be paid

No cemetery payment threshold

Threshold$1,800 or more

Applies toTotal contributions plus the deceased's resources

ResultCemetery representative expenses are not paid

Reduced cemetery payment range

Contribution/resource rangeMore than $1,000 but less than $1,800

Reduction methodReduce the $800 maximum dollar for dollar by the amount above $1,000

Payment limitPay no more than $800 or unpaid expenses, whichever is less

Base cemetery payment threshold

Contribution/resource threshold$1,000 or less

Maximum payment$800 or unpaid expenses, whichever is less

Calculation basisAll contributions plus the resources of the deceased

Claim submission deadline

Submission deadline90 days from the date of death

Required submissionSigned claim form and all necessary supporting documentation

Submission locationFSSA office

Documentation Required

Limit cemetery expenses to eligible interment services

Claim only eligible cemetery or interment expenses, including burial rights, opening and closing the burial plot, an outer container, and services required by cemetery authorities.

Payment is limited to unpaid eligible expenses and the applicable payment maximum.

Documentation Required

Submit signed burial transit permit

A signed burial transit permit must accompany every cemetery expense claim.

Denial Risk

Ensure cremated remains are interred

Cremated remains must be buried in a cemetery to qualify for cemetery payment. A cremation vault on its own does not qualify as a cemetery expense.

Denial Risk

Exclude monuments and headstones

Do not include a monument or headstone as a cemetery expense; these items are not considered eligible cemetery expenses.

Documentation Required

Document contributions and resources

Document all contributions and resources of the deceased because amounts above the applicable exclusion reduce the state-funded payment dollar for dollar. Payment cannot exceed the unpaid eligible expenses.

Funeral contributions and resources up to $2,500 are excluded from the payment calculation.
Amounts above the applicable exclusion are subtracted from the statutory maximum.

Denial Risk

Apply contribution and resource denial thresholds

Apply the no-payment thresholds before recommending payment: no funeral director expenses are paid when contributions plus deceased resources total $3,700 or more, and no cemetery representative expenses are paid when the total is $1,800 or more.

Documentation Required

Submit separate burial claims

The funeral director and cemetery representative must file separately for payment of the deceased recipient’s burial expenses using State Form 35937, Medicaid Recipients Claim to Defray Burial Costs.

Denial Risk

Meet the burial claim deadline

Submit the signed claim form and all necessary supporting documentation to the FSSA office within 90 days of the date of death. Failure to submit all documents within 90 days may result in denial of the claim.

Documentation Required

Document authority and cemetery payment

A funeral director may file and receive payment for cemetery expenses only if the claim includes proof that the director is the cemetery representative or was designated by the cemetery representative. The claim must also include a signed receipt verifying that the cemetery expenses were paid and must note when there was no charge for opening and closing the grave.

Denial Risk

Prevent duplicate or unauthorized cemetery claims

When a funeral director has been designated as the cemetery representative, cemetery claims submitted by any other party will not be paid.

Documentation Required

Verify other burial resources

Identify and verify other available resources and amounts paid by other sources toward burial expenses before recommending payment. If resources are discovered after payment, reimbursement back to FSSA will be requested.

Billing Rule

Certify and route approved claims

For an approved claim, the FSSA Authorized Designee must certify that State Form 35937 is properly completed and that the recommended amount is correct, sign the form, file the original, and submit a copy to Accounts Payable.

Documentation Required

Maintain vendor tax documentation

Any business receiving payment from the Auditor of State must have State Form 53788, Request for Taxpayer Identification Number and Certification, on file. A business that has never received payment through the State Auditor’s office must attach the form to its initial claim.

Billing Rule

Receive vendor reimbursement

Burial expense reimbursements are made to vendors by direct deposit into the account on file through the completed vendor information form, State Form 53788.

Denial Risk

Escalate suspected fraud

FSSA will follow up when inaccurate contribution information is recorded on a funeral or cemetery claim. If collusion, misrepresentation, or apparent fraud by a funeral director or cemetery representative is identified, FSSA will refer the case for prosecution.

The funeral director and/or cemetery representative must obtain the funds as payment in accordance with the Indiana Probate Code

Funeral director expenses

Body preparationReasonable expenses connected with preparation of the body, including cremation

Funeral goods and servicesNecessary clothing, a casket, and funeral services

Transportation and professional servicesTransportation of the body and professional services of the funeral director

Cemetery expenses

Allowable interment expensesBurial rights, opening and closing a burial plot, and provision of an outer container

Authority-required servicesServices required by the cemetery authorities

Requirements and exclusionsCremated remains must be buried in a cemetery; a cremation vault alone, monuments, and headstones are not cemetery expenses

Insurance settlement

Settlement recipientA cash life insurance settlement paid to a surviving relative is the relative's income or resource

Burial useAny portion used for the deceased recipient's burial expenses is treated as a contribution from a relative

Eligibility effectIf the surviving relative is also an applicant or recipient, the settlement may affect eligibility depending on the program

Cemetery representative

DesignationA person may file and receive payment when they are the cemetery representative or have been designated by the cemetery representative

Proof requiredAttach proof of cemetery representative status or designation to the claim

Payment documentationAttach a signed receipt verifying that cemetery expenses have been paid

Other burial resources

Included fundsOther available resources and amounts paid by all other sources toward burial expenses

Verification requirementAmounts paid by other sources must be verified before a payment recommendation is made

Post-payment resourcesResources identified after payment may result in a reimbursement request to FSSA