STATE OF ALASKA
Department of Health and Social Services
Division of Public Assistance
TRANSMITTAL NUMBER: MC #59
MANUAL: Family Medicaid Eligibility Manual
DATE: March 3rd, 2014
This manual change reflects changes in policy and updated income limits based on Federal Poverty Level changes effective March 1st, 2014.
Other changes are either technical in nature or clarifications that are the results of policy questions or 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
Throughout the manual references to Addendum 6 and the Tax Filing thresholds has been removed. We are to take client statement with regards to Tax Filing Status.
5000-1 HISTORY OF MEDICAID
Added a bullet to state that resources are no longer considered for Medicaid eligibility determination due to changes resulting from the Affordable Care Act (ACA).
5005 APPLICATION PROCESS
Added an explanation to say that if an individual has a disability determination already, APA related Medicaid can be examined, or if otherwise eligible for MAGI Medicaid, MAGI Med eligibility can be determined. If they do NOT have a disability determination yet, we determine eligibility for MAGI and if they are ineligible for MAGI we forward the application to the FFM.
5005-3 OTHER FORMS NEEDED
Added a more detailed explanation of the need for the child support cooperation form (1603)
5011-6E PROOF OF US CITIZENSHIP ONLY
Removed bullets pertaining to Bureau of Vital Statistics and Permanent Fund Dividend since those two electronic interfaces are both proof of Citizenship and proof of identity.
5011-6F PROOF OF IDENTITY ONLY
Added explanation of how identity for children under the age of 16 is verified
5012-A DEFINITION OF ALASKA RESIDENCY
Added a definition of residency for individuals under that age of 21
5016-4C FAILURE TO COMPLETE A CHILD SUPPORT FORM
Added that the GEN50c form includes the CSSD 1603a form (Addendum D on the GEN50c)
Added that client statement is acceptable for cooperating with Child Support for the pend period.
5065-A DEFINITIONS
Added a definition for "Minimum Value Standard".
5120-4C THE HOME
Added explanation of how to determine caretaker relative in a home where the child lives part of the time with each parent.
5150 RESOURCES
Added reminder that for MAGI Medicaid resources are not considered.
5152 COUNTABLE RESOURCES
Added reminder that for MAGI Medicaid resources are not considered.
5154 EXEMPT RESOURCES
Added reminder that for MAGI Medicaid resources are not considered.
5156 SPECIAL RESOURCE PROVISIONS
Added reminder that for MAGI Medicaid resources are not considered.
5164-2 SELF-EMPLOYMENT COSTS OF DOING BUSINESS
Added an explanation that for MAGI Medicaid the 50% deduction is no longer used. The actual costs of doing business must be used.
5164-2A EXPENSES ALLOWED AS COST OF DOING BUSINESS
Added an explanation that for MAGI Medicaid the 50% deduction is no longer used. The actual costs of doing business must be used.
5164-5B BUDGETING SEASONAL SELF-EMPLOYMENT INCOME
Added an explanation that for MAGI Medicaid the 50% deduction is no longer used. The actual costs of doing business must be used.
5220 TRANSITIONAL MEDICAID
Added that Transitional Medicaid is also available to MAGI Medicaid recipients.
5704 FORMER FOSTER CARE CHILDREN
Removed bullet saying that Former Foster Care Children is a last resort.
Added a statement that FFCC can be moved to another category of Medicaid if the client chooses.
5707 CONTINUED MEDICAID COVERAGE DURING MAGI TRANSITION PERIOD
Changed section to say that eligible household adults are only certified through March 31st, not one year. Children still receive 12 months CEP.
5710-3 DETERMINING COUNTABLE INCOME FOR EACH MEMBER USING MAGI RULES
Changed flow charts to specify that non-filers income is counted too, unless otherwise exempt.
Added note to explain how and when to count the income of a child under the age of 18.
5715-2 Special Income PROVISIONS
Added Child Support income, Worker's Compensation, Veteran's Disability income, SSI and ATAP/TANF as excluded incomes.
Added to use last year's PFD amount unless this year's amount has been announced.
5715-3 INCOME DISREGARDS
Added an explanation that for MAGI Medicaid the 50% deduction is not usable.
5720 VERIFICATION AND DOCUMENTATION
Added a link to MS 5011 for verification and documentation for identity, citizenship and qualified alien status.
5720-2 VERIFICATION REQUIREMENTS
Added a note explaining how to verify cooperation with Child Support.
Added that no further verification of ID is needed if Citizenship was verified through an electronic interface
Added that the "within 10% compatibility" rule for verifying earned income also applies to unearned income.
5720-3 REASONABLE COMPATIBILITY
Added that 10% compatibility for income is for both earned and unearned.
Added an example showing how 10% compatibility works with unearned income.
5735 (new chapter) HOSPITAL PRESUMPTIVE ELIGIBILITY DETERMINATIONS
Gives an overview of how presumptive hospital eligibility determinations will be made.
Addendum 1 DENALI KID CARE INCOME STANDARDS
Updated FPG Standards in effect as of 03/01/2014
Addendum 2 FAMILY MEDICAID INCOME STANDARDS
Updated FPG Standards in effect as of 03/01/2014
Added information that Family Medicaid tables are used for Medicaid determined prior to 01/01/14
Addendum 3 FAMILY MEDICAID SUBTYPES
Changes the 4M category to " Post-Medicaid due to excess spousal support"
Adds a note beside Medicaid subtype 4M that Child Support is not countable income for MAGI Medicaid.
Addendum 5 MAGI MEDICAID INCOME STANDARDS
Updated FPG Standards in effect as of 03/01/2014