7 AAC 100.554 - Cost-of-care liability determination

(a) A recipient's cost-of-care liability in any given month is the recipient's total monthly income, less the applicable disregards and allowances in (b) and (c) of this section, not to exceed the actual cost of long-term care services paid by the department on behalf of the recipient.

(b) The department will deduct from a recipient's total monthly income the following disregards, as applicable:

(1) a payment from the United States Department of Veterans Affairs for unusual medical expenses or aid and attendance; for a recipient living in the Alaska Veterans' Home (Palmer Pioneers' Home); the disregard in this paragraph is limited to $90;

(2) any portion of a United States Social Security Administration payment that is withheld for the purpose of recovering a previous overpayment;

(3) an SSI payment received by a recipient who is eligible for SSI benefits under 42 U.S.C. 1382 h(a) or (b) (secs. 1619(a) and (b) of the Social Security Act);

(4) an SSI or APA payment that is continued at the rate payable to a recipient living in the community when the individual is in the first 90 days of institutionalization, if that institutionalization is not expected to exceed 90 days;

(5) monthly income of $4 or less from an interest-bearing account;

(6) retroactive SSI or OASDI benefits received in a month that is not the month of intended use as determined by the United States Social Security Administration.

(c) The department will deduct from a recipient's total monthly income the following allowances, as applicable:

(1) a personal needs allowance under 7 AAC 100.558;

(2) a community spouse allowance under 7 AAC 100.560;

(3) a dependent family member allowance under 7 AAC 100.562;

(4) a health insurance premium allowance under 7 AAC 100.564;

(5) an unpaid medical expense allowance under 7 AAC 100.566;

(6) a home maintenance allowance under 7 AAC 100.568.

(d) Repealed 1/1/2011.

(e) A recipient does not have a cost-of-care liability in the month of admission to, or discharge from, a medical institution.

(f) A recipient may make advance payments to a medical institution for a future month's cost-of-care liability.

Notes

7 AAC 100.554

Eff. 7/20/2007, Register 183; am 1/1/2011, Register 196; am 8/1/2020, Register 223, October 2017

Authority:AS 47.05.010

AS 47.07.020

AS 47.07.040