STATE OF ALASKA
Department of Health and Social Services
Division of Public Assistance
TRANSMITTAL NUMBER: MC # 61
MANUAL: Family Medicaid Eligibility Manual
DATE: September 2, 2014
We are making several changes to incorporate new policy and clarify existing policy.
Other changes are either technical in nature or clarifications that are the result 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 dpapolicy@alaska.gov
OVERVIEW OF CHANGES
MS 5005-2 A. What is an Acceptable Form?
MS 5005-7 C. Late Renewals
Clarifies if a renewal is submitted within 90 days of closure, a new application is not required
Clarifies the 90 day renewal process for MAGI medicaid and added examples
MS 5011-4 A. Qualified Alien Arriving on or after 8/22/1996
Clarifies that the original date of entry is used to calculate the five-year waiting period start date
MS 5011-7 B. Medicaid Eligibility during reasonable opportunity period
Updates policy, per CMS , to state than an individual can have more than one reasonable opportunity period
Advises when a fraud referral is appropriate
MS 5018 A. Benefit programs for which application much be made
MS 5018 D. Exemptions for applying for UIB
Changes the language around self-employment and regular income to be more consistent with state regulations
Separates self-employment from regular earnings to more accurately describe requirements and exemptions
Adds a note to clarify an individual with a part time job is not exempt but the earnings may make the individual ineligible for UIB so should not be required to apply
MS 5104-1. Mandatory Household members
Clarifies that step-siblings are not excluded from the household for MAGI Medicaid
Removes note
MS 5120-5 B. Temporary Absence
Adds note to B(3) that temporary absence may include a child who leaves home to attend school, National Guard Youth Corp, or other educational training or treatment
Clarifies that the list of planned temporary absences in this section is not comprehensive by adding "including but not limited to" prior to the short list provided
5120-6 Non Temporary Absences
Deletes children in an educational institution from the non-temporary absence section. This is considered an allowable temporary absence
Adds note to clarify that parent's income may affect the child's eligibility for Medicaid, even though the child is not living with them, if the parents will claim the child as a tax dependent next year
5125 Deprivation
Clarifies that deprivation does not apply to MAGI Medicaid
5160-13 Special Income Provisions
Adds note to clarify wage advances or draws are counted as income in the month received
5164-2 A. Expenses Allowed as Costs of Doing Business
Clarifies that vehicle depreciation is an allowable expense for MAGI Medicaid
5164-3 B. Tax Forms
Updates section to remove depreciation as a self-employment expense that is not allowed
5220-1 Definitions
Revises the definition of parent or other caretaker to include step-parents
5320 Pregnant Woman Postpartum Period
Clarifies that the pregnant woman must apply for Medicaid before the date she gave birth or she is not eligible for the postpartum period, even if she is found eligible for retroactive Medicaid in the birth month
5330 Newborn Child Eligibility
Clarifies that if a pregnant woman applies for Medicaid after the birth of her newborn but she is eligible for retroactive Medicaid coverage in the birth month, the newborn is eligible for Newborn Medicaid
Clarifies that the BA Medicaid subtype should be used for newborns that meet the criteria
5702 Pregnant Women Eligibility
Clarifies that the pregnant woman must apply for Medicaid before the date she gave birth or she is not eligible for the postpartum period, even if she is found eligible for retroactive Medicaid in the birth month
5704 Former Foster Care Children
Corrects error in fourth paragraph as there are only 'two' eligibility criteria listed above, not three
Clarifies that to be eligible for this category, the individual must have aged out of any form of foster care. Eligibility can be verified in EIS by checking for a FSO 060 OCS medicaid case
5715-2 Excluded Income
Clarifies that VA Dependency and Indemnity Benefits are exempt disability payments
Adds and additional exempt income category "payments issues under Title I of the Domestic Volunteer Act of 1973 such as VISTA and AmeriCorps Vista"
5715-3 Special MAGI Income Rules
Clarifies that the amount of last year's PFD amount is used until the current year's PFD amount is officially announced
Adds a note clarifying that the estimated PFD amount provided by Policy for Food Stamp Hold Harmless processing purposes should not be used for MAGI Medicaid
5715-4 MAGI Income Deductions
Clarifies that verification is required for pre-tax payroll deductions and other allowable income tax deductions
5720- 2 A. The following factors of eligibility require proof:
Adds pre-tax payroll deductions and income tax deductions to the factors of eligibility that require proof
5720-2 B. Client statement is acceptable for the following factors if not questionable
Removes unearned income as a type of income where client statement is acceptable verification
5720-3 Reasonable Compatibility
Clarifies how to determine monthly income from DOL information
Clarifies that for unearned income verified with an electronic source (such as unemployment), the verified amount should be used rather than the client stated income amount
Deletes example about UIB as client statement was incorrectly accepted for UIB . UIB is verified electronically
5730 A. Applications submitted through the FFM
Adds information regarding special enrollment periods for FFM applications
5735 Hospital Presumptive Eligibility Determinations
Corrects hospital presumptive period end dated to include both circumstances: 1) when a client submits a full Gen 50C by the end of the approved hospital presumptive period or 2) when a client does not submit a full Gen 50C by the end of the approved hospital presumptive period
Adds a note describing covered services under hospital presumptive eligibility and refers questions to the Medicaid Helpline