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Article 10. Post Eligibility and Cost of Care. Rule 7 AAC 100.550. Applicability to post-eligibility and cost-of-care liability 7 AAC 100.552. Collection of recipient’s cost-of-care liability 7 AAC 100.554. Cost-of-care liability determination 7 AAC 100.558. Personal needs allowance 7 AAC 100.560. Community spouse allowance 7 AAC 100.562. Dependent family member allowance 7 AAC 100.564. Insurance premium allowance 7 AAC 100.566. Unpaid medical expense allowance 7 AAC 100.568. Home maintenance allowance 7 AAC 100.570. Retroactive cost-of-care adjustments 7 AAC 100.579. Definitions related to post-eligibility 7 AAC 100.550. Applicability to post-eligibility and cost-of-care liability. (a) After establishing initial Medicaid eligibility, the department will determine if a recipient must pay a portion of the cost of the recipient’s long-term care services or home and community-based waiver services. If a recipient or a recipient’s representative, on behalf of the recipient, fails to pay the cost-of-care liability for home and community-based waiver services, the department may terminate the recipient’s eligibility for home and community-based waiver services. (b) The post-eligibility requirements of 7 AAC 100.550 — 7 AAC 100.579 apply to an individual

(1) residing in a medical institution and receiving long-term care services, except for an SSI or APA recipient who receives SSI or APA

(A) cash benefits because the individual is temporarily institutionalized for a period of 90 days or less; or

(B) personal needs payments under 7 AAC 40.390; or

(2) receiving home and community-based waiver services and who is determined eligible for Medicaid under 7 AAC 100.002(d)(4) or (8). (Eff. 7/20/2007, Register 183; am 8/1/2020, Register 235) Statutory Authority: