7 AAC 100.312 - Medicaid eligibility for poverty-level children

(a) To be eligible under one of the poverty-level eligibility categories listed in 7 AAC 100.310(a), a child must have monthly household income that does not exceed

(1) 150 percent of the federal poverty guidelines for this state, adopted by reference under 7 AAC 100.980, for the size of the child's household; or

(2) the appropriate income level in AS 47.07.020(b)(13) and may not have current health insurance coverage as described in 7 AAC 100.314.

(b) To determine income eligibility of an applicant child, the department will include in the child's household the child's parents and siblings who live in the same home as the child. Subject to (c) of this section, an applicant or recipient may request that the department include a stepparent and step-siblings in the household if a child common to the parent and stepparent is also included in the household.

(c) If the amount of stepparent income that is given to an applicant child or is deemed to the parent of the applicant child causes the child's household to exceed the income limit, the financial needs and income of the stepparent will be excluded and the applicant child's eligibility redetermined.

(d) If the income of a sibling causes the applicant child's household to exceed the income limit, the financial needs and income of the sibling will be excluded and the applicant child's eligibility redetermined.

(e) Any stepparent or sibling excluded from a household under (c) or (d) of this section must have the stepparent's or sibling's Medicaid eligibility determined separately.

(f) For the purpose of determining financial eligibility for a child under (b) of this section, the department considers a child to be living independently beginning on the first day the child is not living in the home of that child's parent, but the department will not make that determination until that child

(1) has not lived in the home of the child's parent for at least 30 consecutive days;

(2) left home to attend an educational, training, or treatment institution or program that involves a residential living arrangement, including the National Guard Youth Corps;

(3) left home to enter a medical institution or treatment facility in the state that involves a residential living arrangement and that treatment has lasted 30 consecutive days or longer; a child may be transferred from one medical institution or treatment facility directly to another without interrupting the 30-consecutive-day period; or

(4) left home to enter an out-of-state medical institution or treatment facility that involves a residential living arrangement and the department gives prior authorization under 7 AAC 105.130 to a continuous 30-day placement in that facility.

Notes

7 AAC 100.312

Eff. 7/20/2007, Register 183; am 1/1/2011, Register 196; am 10/1/2011, Register 199

Authority:AS 47.05.010

AS 47.07.020

AS 47.07.040