STATE OF ALASKA
Department of Health
Division of Public Assistance
TRANSMITTAL NUMBER: MC #67
MANUAL: Aged, Disabled and Long Term Care Medicaid Eligibility Manual
DATE: December 2, 2024
This year Social Security announced a Cost of Living Allowance (COLACost of Living Allowance) increase effective January 2025. We have updated Addendum 1 and the examples throughout the manual with the following items to reflect the 2.5% increase for 2025:
- An increase to the Long Term Care community spouse resource and income allowance and household member standards;
- An increase to the Excess Home Equity resource maximum;
- An increase to the Special Long Term Care Income Standard;
- Changes in Medicare Part A and B premiums; and
- Changes in Medicare Part D premium and coverage information, including changes to the Low-Income Subsidy program
We have also made several changes to clarify existing policy as a result of policy questions or suggestions from the field. An overview of the changes are listed below.
If you have any questions, please contact the Policy & Program Development Team at hss.dpa.policy@alaska.gov.
506 Medicare
- Revised section to clarify that SSISupplemental Security Income recipients are categorically eligible for Medicaid.
520(A) Application Process
- Revised policy to allow for digital and handwritten signatures created on an electronic device (finder/stylus to screen) effective October 1, 2024.
- Clarified that a request to add other programs to an existing Medicaid application must be done timely or a new application is required.
- Revised note to clarify that FFMFederally Facilitated Marketplace and SSPSelf Service Portal applications are valid for any category of Medicaid but additional information is needed from the household for ADLTCAged, Disabled, and Long Term Care Medicaid categories.
520(C) Proof of United States Citizenship and Qualified Alien Status
- Removed reference to a parent, guardian, or caretaker relative attesting to the identity of a child under the age of 16 by signing an identity declaration (the application) as this is not allowed without a wet signature.
526(D) Payments made from a QIT
- Due to a federal regulation change effective September 30, 2024, removed food from in-kind support and maintenance (ISMIn-Kind Support and Maintenance) calculations.
528(A) Initial Case Processing
- Updated section to clarify that the MED 20 is not completed unless the Medicaid Qualifying Trust is used to establish or maintain Medicaid eligibility.
554(D) Look Back Period
- Updated example due to the COLACost of Living Allowance change.
570(D) Income Disregarded in the Cost of Care Determination
- Changed Palmer Pioneer Home to Alaska Veterans and Pioneers Home due to a name change.
570(E) Allowable Deductions for Cost of Care Determinations
- Updated example of ATAPAlaska Temporary Assistance Program ANIAdult Not Included standard due to the COLACost of Living Allowance change.
570(H) Nursing Home Examples
- Updated example due to the COLACost of Living Allowance change.
570(J) Home and Community Based Waiver Case Examples
- Updated example due to the COLACost of Living Allowance change.
575(B) Application
- Revised section to include other application methods.
580 Medicare Savings Programs
- Due to a federal regulation change effective October 1, 2024, revise section to indicate that if an SSISupplemental Security Income recipient is approved for Medicaid, we must automatically enroll them in QMBQualified Medicare Beneficiaries starting the month following the Medicaid approval.
- Updated QMBQualified Medicare Beneficiaries and SLMBSpecified Low Income Medicare Beneficiaries resource limits.
580(A) Qualified Medicare Beneficiaries
- Revised section to indicate that SSISupplemental Security Income recipients are automatically eligible for QMBQualified Medicare Beneficiaries. Non-SSISupplemental Security Income recipients must have countable income equal to or less than 100% of the FPG.
580(D) Low Income Subsidy Program
Addendum 1 Program Standards
- Updated standards due to the COLACost of Living Allowance change.
- Updated Medicare Part A, Part B, and Part D premiums for 2025.
- Updated Spousal Impoverishment standards for 2025.
Addendum 2 APA Related Medicaid Subtypes, Eligibility Codes, and Waiver Codes
- Removed invalid RPTCResidential Psychiatric Treatment Center Medicaid Subtype.
Addendum 5 Medicaid EIS Notices
Addendum 8 Working Disabled Medicaid Buy-In Procedures
- Revised to include Expanded Refused Cash and LTCLong Term Care Medicaid.
- Revised to include other application methods.
- Changed 1619B report system from Luminist to Mobius.