MC #70 (12/25)

STATE OF ALASKA

Department of Health

Division of Public Assistance

TRANSMITTAL NUMBER: MC #70

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

DATE: December 1, 2025

This year Social Security announced a Cost of Living Allowance ( COLA Cost of Living Allowance ) increase effective January 2026. We have updated Addendum 1 and the examples throughout the manual with the following items to reflect the 2.8% increase for 2026:

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(A) Medicare Enrollment

Revised the note clarifying if an individual applies for Medicare and is denied Part A because they would only be eligible if they pay for part A, Medicaid continues, and the caseworker must make the QMB Qualified Medicare Beneficiaries determination.

520(D) Alaska Native Claims Settlement Act (ANCSA) Payments and Assets

Due to a new bill HR 42 revised section to include:

All ANCSA Alaska Native Claims Settlement Act distributions, including distributions from ANCSA Alaska Native Claims Settlement Act Settlement trusts, received from 7/7/25 - 7/6/30 are excluded as income in the month of receipt and as a resource if retained for aged 65 or older, blind, or disabled individuals.

These distributions are excluded as income in Cost of Care determinations for Special Long Term Care Waiver and institutional cases for the above listed individuals.

523(B) Reasonable Compatibility

Added note clarifying that "interface" should be used as verification in EIS Eligibility Information System for reasonable compatibility as client statement is not allowed for earned income.

523(K ) Development of Income

Added subsection to clarify development of income requirements no longer apply to Medicaid.

525(E) Hardship Exceptions

Clarified that a transfer of asset is the only hardship exception that can be allowed.

528(G) Trust Changes

Clarified the process for trustee changes.

Court paperwork assigning new trustee must be sent to policy for approval.

The Med 20 with new trustee information must be sent to DHCS Division of Health Care Services .

If the original trust is amended it must be sent to policy for review and approval.

554(D) Look Back Period

Updated example due to COLA Cost of Living Allowance change.

570(E)3 Allowable Deduction for Cost of Care Determinations

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

570(G) Retroactive Cost of Care Adjustments

Clarified COCA Cost of Care understated liabilities can be captured in more than one month, such as when lump sum or sums were reported late.

You can increase the cost of care for multiple months when multiple lump sums were received in separate months.

570(H) Nursing Home Examples

Updated example due to COLA Cost of Living Allowance change.

570(J) Home and Community Based Waiver Case Examples

Updated example due to COLA Cost of Living Allowance change.

580(D) Low Income Subsidy (LIS) Program

Updated example due to COLA Cost of Living Allowance change.

Addendum 1 Program Standards

Updated example due to COLA Cost of Living Allowance change.

Updated Medicare Part A, Part B, and Part D premiums for 2026.

Updated 2026 Spousal Impoverishment Standards.