MC #53 (04/20)

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 SSDI Social Security Disability Insurance in order to qualify for Medicare benefits

516 Retroactive Medicaid

Revised section for clarity and to align with MAGI Modified 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 MAGI Modified 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

Updated dates in the examples

Updated DHCS contact email to dhcs.systems@alaska.gov

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