ADDENDUM 1

Refer to APA Addendum 1 for APA Need Standards and Supplemental Security Income Eligibility/Payment Standards.

Year	1/1/2012	1/1/2013	1/1/2014	1/1/2015
Special Long Term Care Income Standard	2,094	2,130	2,163	2,199
Alaska NH Nursing Home Personal Needs Allowance	200	200	200	200
Alaska HCB Personal Needs Allowance	1,656	1,656	1,656	1,656
Alaska ALH Assisted Living Home Personal Needs Allowance	1,396	1,396	1,396	1,396
Maximum Community Spouse Resource Allowance	113,640	115,920	117,240	119,220
Community Spouse Monthly Maintenance Need Standard	2,841	2,898	2,931	2,980.50
Monthly Need Standard for Additional Household Members	947	966	977	993.50

Effective 3/1/2015
	Monthly Federal Poverty Guidelines for Alaska					Annual Federal Poverty Guidelines for Alaska
HH Size	QMB Qualified Medicare Beneficiaries	SLMB Base	SLMB Plus	QDWI	Working Disabled	Low-Income Subsidy (LIS)
HH Size	100%	120%	135%	200%	250%	135%	140%	145%	149%	150%
1	1,227	1,472	1,656	2,454	3,067	19,872	$20,608	$21,344	$21,933	$22,080
2	1,660	1,992	2,241	3,320	4,150	26,892	$27,888	$28,884	$29,681	$29,880
3					5,234	33,912	$35,168	$36,424	$37,429	$37,680
4					6,317	40,932	$42,448	$43,964	$45,177	$45,480
5					7,400	47,952	$49,728	$51,504	$52,925	$53,280
6					8,484	54,972	$57,008	$59,044	$60,673	$61,080
7					9,567	61,992	$64,288	$66,584	$68,421	$68,880
8					10,650	69,012	$71,568	$74,124	$76,169	$76,680
Addl.					1,084	7,020	$7,280	$7,540	$7,748	$7,800

Note:

The QMB , SLMB's, and QDWI eligibility categories follow APA /SSI policy, which recognizes only one and two-person households. The Working Disabled Medicaid Buy-In and the LIS categories use the entire household size to determine the 250% standard.

If SSI Supplemental Security Income was terminated during this period:	Multiply 2015 Social Security income by:	If SSI Supplemental Security Income was terminated during this period:	Multiply 2015 Social Security income by:	If SSI was terminated during this period:	Multiply 2015 Social Security income by:
May - June 1977	.245	Jan. 1989 – Dec. 1989	.503	Jan. 2001 – Dec. 2001	.724
July 1977 – June 1978	.260	Jan. 1990 – Dec. 1990	.526	Jan. 2002 – Dec. 2002	.743
July 1978 – June 1979	.276	Jan. 1991 – Dec. 1991	.555	Jan. 2003 – Dec. 2003	.753
July 1979 – June 1980	.304	Jan. 1992 – Dec. 1992	.575	Jan. 2004 – Dec. 2004	.769
July 1980 – June 1981	.347	Jan. 1993 – Dec. 1993	.593	Jan. 2005 – Dec. 2005	.790
July 1981 – June 1982	.386	Jan. 1994 – Dec. 1994	.608	Jan. 2006 – Dec. 2006	.822
July 1982 – Dec. 1983	.415	Jan. 1995 – Dec. 1995	.625	Jan. 2007 – Dec. 2007	.849
Jan. 1984 – Dec. 1984	.429	Jan. 1996 – Dec. 1996	.641	Jan. 2008 – Dec. 2008	.868
Jan. 1985 – Dec. 1985	.444	Jan. 1997 – Dec. 1997	.660	Jan. 2009 – Dec. 2011	.919
Jan. 1986 – Dec. 1986	.458	Jan. 1998 – Dec. 1998	.674	Jan. 2012 – Dec. 2012	.953
Jan. 1987 – Dec. 1987	.464	Jan. 1999 – Dec. 1999	.683	Jan. 2013 – Dec. 2013	.969
Jan. 1988 – Dec. 1988	.484	Jan. 2000 – Dec. 2000	.700	Jan. 2014 - Dec. 2014	.983

(Due to the recession, there was no cost of living adjustment in Social Security or SSI benefits in January 2010 or 2011. The cost of living increased by 3.6% effective January 2012. Because of this history, the Pickle reduction factor is the same for individuals who lost SSI benefits in 2009-2011.)

Note:

If the last month in which an applicant received SSI while, or immediately before, receiving Social Security was in any of the periods above, multiply the present year amount of the Social Security by the corresponding years reduction factor.

MEDICARE PART A MONTHLY PREMIUM
Year	2013	2014	2015
<30 qtrs.	$441	$426	$407
>30 -<39 qtrs.	$243	$234	$234

QMB, SLMB, & SLMB+ RESOURCE LIMITS
Year	2013	2014	2015
Individual	$7,080	$7,160	$7,280
Couple	$10,620	$10,750	$10,930

MEDICARE PART - B MONTHLY PREMIUM
Year	2013	2014	2015
	$104.90	$104.90	$104.90

EXCESS HOME EQUITY
Year	2013	2014	2015
	$536,000	$543,000	$552,000