STATE OF ALASKA

Department of Health and Social Services

Division of Public Assistance

TRANSMITTAL NUMBER:  MC Manual Change #53

MANUAL:  Family Medicaid Eligibility Manual

DATE:  March 1, 2012

We are making several changes to clarify existing policy as a result of suggestions from the field. 

Highlights of these policy revisions are described below. If you have any questions please contact the Policy and Program Development Team at 465-3382 or email dpapolicy@alaska.gov.

OVERVIEW OF CHANGES

MS 5008  Retroactive Medicaid

• Adds language to indicate that the eligibility criteria for the same category of Medicaid the family is currently receiving or was receiving at the time requested is used in determining eligibility for Retroactive Medicaid.
• Adds language to indicate that Retroactive Medicaid can be used to determine whether a Medicaid applicant or recipient would have been eligible for Family Medicaid in three of the last six months when determining eligibility for Post Medicaid, including a link to Section 5210.

MS 5011-4  Five Year Waiting Period

• Adds a link to the new subsection explaining when to add a household member who now meets the 5 year wait period requirement.

• Adds a new subsection and examples to demonstrate when benefits begin at the end of the five-year waiting period.

MS 5020-B  Family Medicaid Policies that do not Apply  to Under 21 and Denali Kidcare

• Removes outdated reference in subsection three that states that the last five months of Transitional Medicaid use the Federal Poverty Guidelines for Alaska.  MC Manual Change #43 gave eligible households a full 12 months of Transitional Medicaid.  Previous policy gave households 7 months of Transitional Medicaid and then used the FPG Federal Poverty Guideliness to determine eligibility for an additional 5 months.

MS 5104-1  Mandatory Household Members

• Adds a note to clarify a half-sibling living in the home may not be included in the assistance unit unless the adult qualifies as a caretaker relative to the child, but must have eligibility determined for DKC Denali KidCare instead. 

MS 5104-5  Children Receiving SSI or Foster Care Maintenance Payments

• Revises language to indicate that an adult may be the only FM Family Medicaid household member if they are the caretaker relative of a child receiving SSI Supplemental Security Income.  Previous policy indicated that an adult may be the only FM Family Medicaid household member if they are the parent of a child receiving SSI Supplemental Security Income.  This change is being made to align with state Medicaid regulations.

MS 5104-6  Individuals Not Included in the Household and Whose Income and Resources Do Not Count

• Adds a note to clarify a half-sibling living in the home may not be included in the assistance unit unless the adult qualifies as a caretaker relative to the child, but must have eligibility determined for DKC Denali KidCare instead.

• Adds a link to Section 5120-4B for information about trial visits for OCS Office of Children's Services children.

MS 5104-7  Individuals Included in the Household and Whose Income and Resources Do Count, but Who Are Not Eligible for Coverage

• Updates term “5-year bar” to “five-year waiting period” in subsection four to align with the rest of the manual for a parent of a dependent child, when the parent is ineligible for Medicaid because they are a qualified alien subject to the five-year waiting period, but their income and resources do count in the FM Family Medicaid eligibility determination.
• Updates manual section for the five-year waiting period from 5011-5 to 5011.

MS 5104-9  Pregnant Woman Considerations

• Adds a note to indicate if citizenship or identity is not verified by the 90th day, FM Family Medicaid 3^rd trimester pregnant woman coverage will end.  Adds a link to Section 5011-6A.

MS 5120  Living in the Home of a Caretaker Relative

• Adds a note to indicate that DKC Denali KidCare does not require a caretaker relative.

MS 5120-1  Definition of a Caretaker Relative 

• Adds language that indicates that biological relatives, whose legal and financial relationship to the dependent child has been severed through an adoption, may still be considered caretaker relatives.  This change is being made to align with TA Temporary Assistance MS Manual Section 712-1 and state Medicaid regulations.

• Adds language to indicate that if a child fails to verify a required relationship, the child will not be considered a household member for Family Medicaid purposes. Adds a link to Section 5000-5B.

• Adds language to indicate that if a child’s FM Family Medicaid case is denied, the caseworker should always review the case for DKC Denali KidCare eligibility.

MS 5120-4B  When the Home is in the Process of Being Established

• Adds language to indicate that when a child in OCS custody is placed at home for a trial visit, they are considered part of the FM Family Medicaid  household, but are not eligible for FM Family Medicaid coverage because they will continue to receive Title IV-E Medicaid.  This allows the parent(s) to apply for FM Family Medicaid coverage for themselves.  Adds a link to Administrative Procedures Manual Section 124-5.

MS 5120-4D  Child Resides with Both Parents

• Revises language to indicate that if a child lives with both parents, deprivation exists if the household has deficient employment.  MC Manual Change #35 clarified this policy change in related Section 5125-2, but did not change this section.

MS 5150  Resources

• Adds a note to clarify that Denali Kidcare excludes all resources.

MS 5165-1B  Monthly Earned Income Deduction

• Clarifies that the $150 plus 33% earned income deduction is only given to new members who enter a FM Family Medicaid recipient household and lists eligibility categories that are not eligible for this earned income deduction.

• Adds language and an example to indicate that an individual who never left a recipient household and was not previously included in the FM Family Medicaid case is considered a recipient for the purposes of the earned income deduction.

• Adds an example to illustrate that a DKC Denali KidCare recipient is not eligible for the $150 plus 33% earned income deduction.

MS 5166-1  Military Pay

• In subsection A(1), clarifies the amount of money used from a joint account by a deployed individual is not countable income to the family.

• In subsection B(2)(d), adds SAVE pay to list of excluded military income.

• In subsection B(2)(d), Budgeting Combat Pay #1, clarifies only the amount of military pay provided to the household is countable income. 

MS 5185-2A  New Member Enters Household

• Clarifies that the same verification rules apply when adding new household members to an existing case that apply at application and adds a link to the verification section in section 5000-4. 
• Clarifies that the $150 plus 33 percent earned income deduction is only given to new members who enter a FM Family Medicaid recipient household and provides a link to section 5165-1B for when to allow this earned income deduction.

MS 5210  Post Medicaid -- Increased Child Support

• Adds language to indicate the four month Post Medicaid eligibility period begins the first month after the household became ineligible for Family Medicaid.  Previous policy indicated that the four month Post Medicaid eligibility period begins the month the household became ineligible for Family Medicaid.  This change is being made to align with state Medicaid regulations.

• Adds language to indicate that Retroactive Medicaid months can be used to determine whether a household would have been eligible for Family Medicaid in three of the last six months when determining eligibility for Post Medicaid.  Adds a link to section 5008.

MS 5310-A  General Eligibility Criteria

• Adds a note to indicate if citizenship or identity is not verified by the 90th day, pregnant woman coverage will end.  Adds a link to Section 5011-6A.

MS 5320  Pregnant Woman Postpartum Eligibility

• Adds a note to indicate if citizenship or identity is not verified by the 90th day, pregnant woman postpartum coverage will end.  Adds a link to Section 5011-6A.

MS 5340-D  Period of Eligibility

• Revises reference to section 5080 to 5008 (Retroactive Medicaid) and adds a link.

MS 5600-A  Definitions

• Revises manual section where the definition of non-qualified alien is located from 5011-8 to 5011-5.

• Revises manual section where the definition of qualified alien is located from 5011-3 to 5011-2.

• Updates term “five-year bar” to “five-year waiting period” to align with the rest of the manual.

Addendum 1  Denali KidCare Income Standards

• Updates DKC Denali KidCare income standards to reflect the federal poverty guideline changes effective March 2012.

Addendum 2  Family Medicaid Income Standards

• Updates Self-Employment income annualization standards to reflect the poverty guideline changes effective March 2012.

Addendum 4  The Leave and Earnings Statement

• Revises language to indicate that SAVE pay is a type of combat pay.  This corrects an error in MC #51.  Whether or not this counts as income varies. Adds a link to FM MS 5166-1B(2)(d). 

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