7 AAC 100.502 - Long-term care eligibility criteria
(a) To be
financially eligible for Medicaid under
7
AAC 100.002(d) (4) while living in a
medical institution or under
7
AAC 100.002(d) (8) while receiving
home and community-based waiver services, an applicant or recipient may not
(1) be subject to or within a
transfer-of-asset penalty period under
7
AAC 100.510(d) - (e);
(2) have nonexcluded resources that exceed
the limits applicable under
7
AAC 100.400(a) (14), after the
spousal allocation requirements of
7
AAC 100.506 are applied;
(3) own a home that has an equity value that
exceeds $500,000; this paragraph does not apply if residing in the home is the
applicant's or recipient's
(A)
spouse;
(B) child under 21 years of
age; or
(C) child who is blind, as
set out in 7 AAC 40.140(a),
or disabled, as set out in
7
AAC 40.170(a); or
(4) have total monthly income that
exceeds the amount set out in
AS
47.07.020(b)(6).
(b) In addition to the meeting the
requirements of (a) of this section, to be eligible under
7
AAC 100.002(d) (4) an individual
residing in a medical institution must
(1)
have resided in a medical institution for at least 30 consecutive
days;
(2) require the level of care
provided in
(A) an intermediate care facility
or skilled nursing facility as determined by the department in accordance with
7
AAC 140.505; or
(B) an intermediate care facility for the
mentally retarded as determined by the department in accordance with
7
AAC 140.600; and
(3) be authorized by the department for
admission, transfer, or continuing placement in a long-term care facility in
accordance with
7
AAC 140.500 -
7
AAC 140.595 or
7
AAC 140.600 -
7
AAC 140.640.
(c) If an individual dies on or before the
30th consecutive day that the individual resides in a medical institution, the
department considers the individual to have met the 30-day
requirement.
(d) In addition to
meeting the requirements of (a) of this section, to be eligible under
7
AAC 100.002(d) (8) and receive home
and community-based waiver services while living at home or in an assisted
living home an individual must
(1) meet the
requirements of one of the home and community-based waiver recipient categories
identified in
7
AAC 130.205(d), as determined by the
department; and
(e) If an applicant under (d) of this section
is a child who has already been determined to be disabled, the income and
resources of the child's parent are not counted, even if the child is living at
home with the child's parent.
(f)
An applicant or recipient who is ineligible under (a)(2) of this section, is
not precluded from Medicaid eligibility under another eligibility category
identified in
7
AAC 100.002.
Notes
Authority:AS 47.05.010
AS 47.07.020
AS 47.07.040
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