(1) For purposes of determining eligibility for modified adjusted gross income (MAGI)–based Washington apple health (WAH) (see WAC 182-509-0300
) income is considered available to a person if:
(a) An individual in the person's medical assistance unit receives or can reasonably predict that he or she will receive the income.
(b) The income must be counted based on rules under chapter 182-509
(c) The person has control over the income, which means the income is available to them. If the person has a representative payee, protective payee, or other individual who manages the income on the person's behalf, it is considered as if the person has control over this income.
(d) The person can use the income to meet current needs.
(2) Income that is included in the person's taxable gross income which is required to be reported to the Internal Revenue Service (IRS) is considered as available even if it is paid to someone else or withheld to pay a garnishment, lien or other obligation. (For example, a person manages a block of apartments and lives in one of the apartments. The employer withholds a portion of the person's monthly wages as rent due for the apartment in which he resides. The income that is counted is the gross amount prior to the deduction for rent.)
(3) The agency may conduct post-eligibility reviews of health care applications as described in WAC 182-503-0050
. Upon request by the agency, a person must provide proof about a type of income, including submitting clarification on:
(a) Who owns the income;
(b) Who has legal control of the income;
(c) The amount of the income; or
(d) If the income is available.
[Statutory Authority: RCW 41.05.021
, Patient Protection and Affordable Care Act (P.L. 111-148), 42 C.F.R. §§ 431, 435, 457, and 45 C.F.R. § 155. WSR 14-01-021, § 182-509-0315, filed 12/9/13, effective 1/9/14.]