MC #67 (12/24)

STATE OF ALASKA

Department of Health

Division of Public Assistance

TRANSMITTAL NUMBER: MC #67

MANUAL: Aged, Disabled and Long Term Care Medicaid Eligibility Manual

DATE: December 2, 2024

This year Social Security announced a Cost of Living Allowance ( COLA Cost of Living Allowance ) increase effective January 2025. We have updated Addendum 1 and the examples throughout the manual with the following items to reflect the 2.5% increase for 2025:

An increase to the Long Term Care community spouse resource and income allowance and household member standards;

An increase to the Excess Home Equity resource maximum;

An increase to the Special Long Term Care Income Standard;

Changes in Medicare Part A and B premiums; and

Changes in Medicare Part D premium and coverage information, including changes to the Low-Income Subsidy program

We have also made several changes to clarify existing policy as a result of policy questions or suggestions from the field. An overview of the changes are listed below.

If you have any questions, please contact the Policy & Program Development Team at hss.dpa.policy@alaska.gov .

OVERVIEW OF CHANGES

506 Medicare

Revised section to clarify that SSI Supplemental Security Income recipients are categorically eligible for Medicaid.

520(A) Application Process

Revised policy to allow for digital and handwritten signatures created on an electronic device (finder/stylus to screen) effective October 1, 2024.

Clarified that a request to add other programs to an existing Medicaid application must be done timely or a new application is required.

Revised note to clarify that FFM Federally Facilitated Marketplace and SSP Self Service Portal applications are valid for any category of Medicaid but additional information is needed from the household for ADLTC Aged, Disabled, and Long Term Care Medicaid categories.

520(C) Proof of United States Citizenship and Qualified Alien Status

Removed reference to a parent, guardian, or caretaker relative attesting to the identity of a child under the age of 16 by signing an identity declaration (the application) as this is not allowed without a wet signature.

526(D) Payments made from a QIT

Due to a federal regulation change effective September 30, 2024, removed food from in-kind support and maintenance ( ISM In-Kind Support and Maintenance ) calculations.

528(A) Initial Case Processing

Updated section to clarify that the MED 20 is not completed unless the Medicaid Qualifying Trust is used to establish or maintain Medicaid eligibility.

554(D) Look Back Period

Updated example due to the COLA Cost of Living Allowance change.

570(D) Income Disregarded in the Cost of Care Determination

Changed Palmer Pioneer Home to Alaska Veterans and Pioneers Home due to a name change.

570(E) Allowable Deductions for Cost of Care Determinations

Updated example of ATAP Alaska Temporary Assistance Program ANI Adult Not Included standard due to the COLA Cost of Living Allowance change.

570(H) Nursing Home Examples

Updated example due to the COLA Cost of Living Allowance change.

570(J) Home and Community Based Waiver Case Examples

Updated example due to the COLA Cost of Living Allowance change.

575(B) Application

Revised section to include other application methods.

580 Medicare Savings Programs

Due to a federal regulation change effective October 1, 2024, revise section to indicate that if an SSI Supplemental Security Income recipient is approved for Medicaid, we must automatically enroll them in QMB Qualified Medicare Beneficiaries starting the month following the Medicaid approval.

Updated QMB Qualified Medicare Beneficiaries and SLMB Specified Low Income Medicare Beneficiaries resource limits.

580(A) Qualified Medicare Beneficiaries

Revised section to indicate that SSI Supplemental Security Income recipients are automatically eligible for QMB Qualified Medicare Beneficiaries . Non- SSI Supplemental Security Income recipients must have countable income equal to or less than 100% of the FPG.

580(D) Low Income Subsidy Program

Updated resource limits.

Addendum 1 Program Standards

Updated standards due to the COLA Cost of Living Allowance change.

Updated Medicare Part A, Part B, and Part D premiums for 2025.

Updated Spousal Impoverishment standards for 2025.

Addendum 2 APA Related Medicaid Subtypes, Eligibility Codes, and Waiver Codes

Removed invalid RPTC Residential Psychiatric Treatment Center Medicaid Subtype.

Addendum 5 Medicaid EIS Notices

Updated notice listing.

Addendum 8 Working Disabled Medicaid Buy-In Procedures

Revised to include Expanded Refused Cash and LTC Long Term Care Medicaid.

Revised to include other application methods.

Changed 1619B report system from Luminist to Mobius.