STATE OF ALASKA
Department of Health and Social Services
Division of Public Assistance
TRANSMITTAL NUMBER: MC #53
MANUAL: Aged, Disabled and Long Term Care Medicaid Eligibility Manual
DATE: April 1, 2020
We have updated the 2020 Federal Poverty Level guidelines for income eligibility effective April 1, 2020. We have also updated other sections that use Federal Poverty Level guidelines for income eligibility.
This manual change also consists of several technical changes or clarifications as a result of suggestions from the field. Highlights of these revisions are described below. If you have any questions please contact the Policy and Program Development Team at e-mail dpapolicy@alaska.gov.
OVERVIEW OF CHANGES
506(A) Medicare Eligibility
- Clarified that an individual must be receiving SSDISocial Security Disability Insurance in order to qualify for Medicare benefits
516 Retroactive Medicaid
- Revised section for clarity and to align with MAGIModified Adjusted Gross Income Medicaid
520(A) Application and Review Process
- Clarified that an application and interview are required when an individual is moving from a MAGIModified Adjusted Gross Income Medicaid category to an Old Age/Disability related Medicaid category
520(B) Proof of United States Citizenship and Qualified Alien Status
- Replaced Bureau of Vital Statistics (BVS) with Health Analytics & Vital Records (HAVR)
528(A) Initial Case Processing
- Clarified that a trust should not be sent to policy for review until the interview has been completed and the application is ready to be approved (other than the trust approval)
528(G) Trust Changes
- Clarified that amended trusts and the associated court paperwork must be sent to policy for approval
530(C) Use of the Refused Cash Medicaid Subtype
- Removed Expanded Refused Cash income limits and added a link to it on the ADLTC Addendum 1
533(A) TEFRA Eligibility
- Clarified that when a TEFRA child is turning 18, they must be referred to apply for SSI
- Added that Child Support received on behalf of a TEFRA child is countable income to the child
533(B) TEFRA Conversions
- Clarified that if a child's SSI benefit stops, the caseworker must evaluate the child's eligibility for MAGI Medicaid, TEFRA, and a CEP.
533(E) TEFRA Reviews
- Clarified that at the time of review, the caseworker must check the child's age. If the child is turning 18 years old, they must be referred to apply for SSI.
534(K) Example of an Eligibility Determination
- Updated examples with 2020 Federal Poverty Level Changes and replaced APA Need Standard with Refused Cash standard
534(M) Example of an Eligibility Determination With a Medicaid Qualifying Trust
- Updated examples with 2020 Federal Poverty Level Changes and replaced APA Need Standard with Refused Cash standard
554(E) Penalty Start Date
- Clarified when a TOA penalty begins
554(L) Transfer Penalty and Partial Months
561 EIS HCB Waiver Codes
- Removed charts throughout this section as this process information is not maintained by the policy unit
- Move eligibility and waiver codes to Addendum 2
570(E) 6 Home Maintenance Allowance
- Updated the amount used for home maintenance allowance as equal to the Expanded Refused Cash Medicaid income limit instead of the APA need/payment standard
570(H) Nursing Home Examples
- Updated examples with 2020 Community Spouse Monthly Maintenance Need Standards
570(J) Home and Community-Based Waiver Case Examples
- Updated examples with 2020 Community Spouse Monthly Maintenance Need Standards
576(F) EIS Information
- Deleted section and added information to Addendum 2
580 Medicare Savings Programs
- Updated QMB & SLMB resource limits
Addendum 1
- Updated with 2020 Federal Poverty Level Changes
- Added 2020 Expanded Refused Cash Income Limits
- Updated QMB, SLMB, and SLMB+ Resource Limits
Addendum 2
- Added subtypes for Undocumented Illegal Aliens due to CMS reporting requirements
- Added a list of eligibility and waiver codes
Addendum 4
- Added the Help Desk will contact Policy to determine if the request is valid and can be approved
Addendum 7
- Revised information for Medicaid Part D, including a new link to the SDS website