513 ALASKA RESIDENCY

513 ALASKA RESIDENCY

The agency must provide Medicaid to eligible residents of the State, including residents that are absent from the State.

Note: If during the application process DPA Division of Public Assistance finds that an individual has open public assistance benefits of any kind in another state or they are an SSI Supplemental Security Income recipient with an out of state address, the individual is claiming to be a resident of that other state. Until DPA Division of Public Assistance verifies that the individual has reported their move to Alaska to the other state or SSI Supplemental Security Income , the caseworker must find their Alaska residency questionable. Once residency is no longer questionable, we can start benefits in Alaska as outlined in the program policy manuals.

513 A. ALASKA RESIDENCY REQUIREMENTS

If Alaska residency is already established for an individual, the individual's residency continues until he or she abandons it.

If residency requirements are questionable for an individual, determine if the individual meets one of the following conditions:

Lives in Alaska and intends to continue living in Alaska permanently or for an indefinite period of time, even without a fixed address; or

Entered the state looking for a job; or

Entered the state with a job commitment.

Residency depends on a person's intent or purpose in coming to the state at the time of application. An individual is not considered to be an Alaska resident if he or she is in Alaska for a temporary reason such as a vacation or a business trip.

1. Residency of a Minor Child

A child is a resident of the state in which the parent or caretaker is a resident.

Example: A family consisting of dad and mom who are in the U.S. United States on student Visas, attending the University of Anchorage, and one child that was born in the U.S. United States applies for Medicaid. When asked, they declare they intend to return to their home country when finished with school. Since the parents do not intend to remain Alaska residents indefinitely, they are ineligible for Medicaid and the child, although a citizen, is not considered a resident of Alaska, as the parents do not meet residency requirements.

2. Residency of a Student

A full-time time student from another state is not considered to be an Alaska resident if the student is 18 to 22 years old and all three of the following conditions are met:

1. Neither of the student’s parents live in Alaska;

2. The student is claimed as a tax dependent by a person who is a resident of another state; and

3. The student is applying for Medicaid on his or her own behalf.

513 B. TEMPORARY ABSENCE AND RESIDENTS RESIDING OUT OF THE STATE

A person may be temporarily out of state. Medicaid applicants or recipients may not be denied or terminated because an individual is temporarily absent from the state if that individual intends to return to the state when the purpose of the absence has been accomplished, unless another state has determined that the individual is a resident for purposes of receiving Medicaid. There is not a specified period before someone loses Alaska State residency. However, the person must demonstrate intent to continue to reside in Alaska. If it is suspected a household has moved out of state, attempts should be made to contact the household. There is no need to contact the other state.

For an individual who moves out of Alaska permanently, close the case with timely notice of adverse action.

Note: Unlike SSI Supplemental Security Income and APA Adult Public Assistance policy, an individual may not be excluded from Medicaid because they have exceeded the APA Adult Public Assistance temporary absence policy.

Example 1: A client who is receiving Medicaid must stay with her ill grandmother in another state. She may be gone for several months but she is maintaining her apartment in Alaska. Therefore, she is considered a resident of Alaska. Example 2 : A client leaves Alaska to take a temporary job in another state. She is planning to return when the job ends which may be in about 3 to 6 months. She will be renting an apartment in the other state and will not be keeping her residence or belongings here. She is no longer considered a resident of Alaska.

A temporary absence from the state before or after submitting an application, but before eligibility is determined, does not constitute abandonment of residency if the absence occurred for a specific purpose that did not involve intent to change residence and the individual has a plan to return to Alaska at a future date.

Even though an Alaska Medicaid recipient is temporarily absent from the state, Medicaid will only pay for services provided out of state if they are prior authorized by Health Management Systems (HMS), and the out-of-state provider is enrolled in the Alaska Medicaid program.

513 C. IF RESIDENCY IS QUESTIONABLE

Ask whether the intent is to remain in Alaska. If the intent is to remain in Alaska then ask the following:

For temporary visa holders, what has changed in their circumstances to change their intent filed with their current visa? No verification is needed; document the intent and determine if the intent is reasonable.

Lawfully present aliens in the U.S. United States with current un-expired student, business, religious workers or tourist/visitor visas are admitted for a temporary stay depending on the type of visa. These visa holders may have changes in their circumstances that will allow them to change their status with USCIS U.S. Citizenship and Immigration Services while in the U.S. United States The exception is tourist/visitor holders, who are rarely eligible for adjustment of their status while still in the U.S United States .

For Medicaid eligibility, at each application or renewal, temporary visa holders must show that their visa is still in effect. All temporary visa holders excluding business visa holders must be asked their intent to remain an Alaska resident when their current visa expires.

For all individuals with questionable residency, is the individual keeping a home, property or residence in the state/country that person left?

If no, the individual meets residency requirements with the declared intent.

If yes, does the person have the residence/property listed for sale, if not why?

If individual is still maintaining home/property or residence and cannot document why, that person is not an Alaska resident and the request for medical assistance should be denied.

An individual, who states the intent to return home after completing school or the visa expires, does not meet residency requirements.

An individual, who enters the state with a job commitment or to search for work, meets residency requirements. This includes business visa holders.

Example 1: A family consisting of dad, mom, and two children have just moved to Alaska from California in search of seasonal work. They maintain a home in California to which they intend to return after the season is over. They apply for Medicaid as they search for work. Because they entered Alaska in search of work, they meet residency requirements. Example 2: A family consisting of dad, mom, and two children have just moved to Alaska from Oregon due to dad's new job. They apply for Medicaid due to one child's sudden illness. They have their home in Oregon rented and will be listing the home for sale when the market improves. Because they entered Alaska with a job commitment, they meet residency requirements. If they meet all other eligibility criteria, the children are eligible for Medicaid. Example 3: A non-immigrant family with two children applies for Emergency Treatment for Aliens. They submit current visas for the entire family with R1 and R2 codes (religious workers and dependents). When asked, they declare they intend to remain Alaska residents, and they have no home or property in their home country. Because they entered Alaska with a job commitment, they are considered residents. Example 4: A non-immigrant family consisting of mom, dad, and one child applies for Emergency Treatment for Aliens. They submit current F1 and F2 visa's (foreign student and dependents) for the family and proof of pregnancy for mom. They state they intend to remain in Alaska. When asked about their temporary visa and their intention to remain in Alaska, they say they hope that an employer will petition for their adjustment once school is completed. They declare they have no home or property in their home country. Since they stated the intent to remain an Alaska resident and are not maintaining a residence in their home country they meet residency requirements. Example 5: A 21-year-old student attending University of Fairbanks applies for Pregnant Women Medicaid. She supplies her school grant and loan information which states she is attending the university as a non-resident. When asked her intentions when she finishes school she states she intends to return to Montana where her family lives when she completes her degree in 2 years. Since she does not meet residency requirements, she is ineligible for Medicaid. Example 6: A husband and wife, admitted to the U.S. with F1 student visas apply for Emergency Treatment for Aliens for the husband due to a recent hospitalization. The applicant's state they intend to remain in Alaska indefinitely, however, they have a home that is not listed for sale in their home country. When asked what they plan to do with the home, the family has no response. Since they are maintaining a residence in their home country, Emergency Treatment for Aliens coverage is denied for failure to meet residency requirements.

513 D. VERIFICATION OF RESIDENCY

A statement from the individual is sufficient to document his or her intent unless there is conflicting information. The caseworker may require applicants or recipients to provide proof of Alaska residency if there is reason to doubt their state residency. Items that can be used to prove state residency include, but are not limited to: rent receipts, utility bills, in-state school tuition, current driver’s license, current voter’s registration card, city directory, and statements from other individuals who are aware of the household’s situation.

513 E. PERMANENT ADDRESS NOT REQUIRED

An applicant or recipient is not required to have a permanent address as a condition of eligibility. If an applicant or recipient does not have a permanent address, provisions are made to assure the person receives their Medicaid card or coupons. The recipient should be given a choice of an alternate mailing address for their Medicaid card or coupons.

513 F. OUT-OF-STATE INDIVIDUAL MOVES TO ALASKA

When an individual has received benefits in another state prior to applying in Alaska, verify termination of benefits in the other state before establishing eligibility for Alaska benefits.

Alaska Medicaid benefits may not be issued to a person who has been issued Medicaid benefits in another state in the same month, unless case closure in the other state has been verified and the following conditions are met:

The other state was unable to or did not stop the benefit issuance before the individual arrived in this state; and

The applicant states benefits issued from the other state were not used to pay for any medical services provided in the month.

513 G. OUT-OF-STATE TREATMENT IN A MEDICAL INSTITUTION

If an Alaska state agency, such as Office of Children’s Services (OCS), places an individual in an out-of-state medical institution or foster care setting, that individual is considered to be an Alaska resident, except for Title IV-E individuals (see MAGI MS 829 ). If the recipient leaves the medical institution or foster care setting (and legal custody) of the state of Alaska, the state of residence, for Medicaid purposes, is the state where the individual is physically located. If the recipient leaves an out-of-state medical institution, but remains out of state temporarily for follow up or transitional care, that individual is considered only to be temporarily absent and remains a resident of Alaska as long as the treatment plan calls for the individual to return to Alaska.

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