ADDENDUM 1

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

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 2013 Social Security income by:	If SSI Supplemental Security Income was terminated during this period:	Multiply 2013 Social Security income by:	If SSI was terminated during this period:	Multiply 2013 Social Security income by:
May - June 1977	.253	Jan. 1989 – Dec. 1989	.519	Jan. 2001 – Dec. 2001	.748
July 1977 – June 1978	.268	Jan. 1990 – Dec. 1990	.543	Jan. 2002 – Dec. 2002	.767
July 1978 – June 1979	.285	Jan. 1991 – Dec. 1991	.573	Jan. 2003 – Dec. 2003	.778
July 1979 – June 1980	.314	Jan. 1992 – Dec. 1992	.594	Jan. 2004 – Dec. 2004	.794
July 1980 – June 1981	.358	Jan. 1993 – Dec. 1993	.612	Jan. 2005 – Dec. 2005	.815
July 1981 – June 1982	.399	Jan. 1994 – Dec. 1994	.628	Jan. 2006 – Dec. 2006	.849
July 1982 – Dec. 1983	.428	Jan. 1995 – Dec. 1995	.645	Jan. 2007 – Dec. 2007	.877
Jan. 1984 – Dec. 1984	.443	Jan. 1996 – Dec. 1996	.662	Jan. 2008 – Dec. 2008	.896
Jan. 1985 – Dec. 1985	.459	Jan. 1997 – Dec. 1997	.681	Jan. 2009 – Dec. 2011	.949
Jan. 1986 – Dec. 1986	.473	Jan. 1998 – Dec. 1998	.696	Jan. 2012 – Dec. 2012	.983
Jan. 1987 – Dec. 1987	.479	Jan. 1999 – Dec. 1999	.705
Jan. 1988 – Dec. 1988	.499	Jan. 2000 – Dec. 2000	.722

(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.

Year	9/1/2010	1/1/2011	7/1/2012	1/1/2013
Special Long Term Care Income Standard	2,022	2,022	2,094	2,130
Alaska NH Nursing Home Personal Needs Allowance	75	75	200	200
Alaska HCB Home and Community-Based 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	109,560	109,560	113,640	115,920
Community Spouse Monthly Maintenance Need Standard	2,739	2,739	2,841	2,898
Monthly Need Standard for Additional Household Members	913	913	947	966

Effective 3/1/2013
	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 Low Income Subsidy)
HH Size	100%	120%	135%	200%	250%	135%	140%	145%	149%	150%
1	1,196	1,435	1,615	2,392	2,990	19,373	20,090	20,808	21,382	21,525
2	1,615	1,938	2,181	3,230	4,038	26,163	27,132	28,101	28,877	29,070
3					5,086	32,954	34,174	35,395	36,371	36,618
4					6,134	39,744	41,216	42,688	43,866	44,160
5					7,182	46,535	48,258	49,982	51,361	51,705
6					8,230	53,325	55,300	57,275	58,855	59,250
7					9,278	60,116	62,342	64,569	66,350	66,795
8					10,326	66,906	69,384	71,862	73,845	74,340
Addl.					1,048	6,791	7,042	7,294	7,495	7,545

MEDICARE PART A MONTHLY PREMIUM
Year	2011	2012	2013
<30 qtrs.	$443	$451	$441
>30 -<39 qtrs.	$244	$248	$243

MEDICARE PART - B MONTHLY PREMIUM
Year	2011	2012	2013
	$96.40	$99.90	$104.90

QMB Qualified Medicare Beneficiaries, SLMB, & SLMB+ RESOURCE LIMITS
Year	2011	2012	2013
Individual	$6,600	$6,940	$7,080
Couple	$9,910	$10,410	$10,620

EXCESS HOME EQUITY
Year	2011	2012	2013
	$506,000	$525,000	$536,000