(1) To be eligible for long-term care (LTC) services, a person must:
(a) Meet the general eligibility requirements for medical programs under WAC 182-503-0505
(i) An adult age nineteen or older must meet citizenship and immigration status requirements under WAC 182-503-0535
(2)(a) or (b);
(ii) A person under age nineteen must meet citizenship and immigration status requirements under WAC 182-503-0535
(2)(a), (b), (c), or (d); and
(iii) If a person does not meet the requirements in (a)(i) or (ii) of this subsection, the person is not eligible for medicaid and must have eligibility determined under WAC 182-513-1319
(c) Meet the functional eligibility under:
(i) Chapter 388-106
WAC for a home and community services (HCS) home and community based (HCB) waiver or nursing facility coverage; or
(ii) Chapter 388-828
WAC for developmental disabilities administration (DDA) HCB waiver or institutional services; and
(d) Meet either:
(ii) MAGI-based criteria under WAC 182-503-0510
(2), if residing in a medical institution. A person who is eligible for MAGI-based coverage is not subject to the provisions under subsection (2) of this section.
(2) A supplemental security income (SSI) recipient or a person meeting SSI-related criteria who needs LTC services must also:
(a) Not have a penalty period of ineligibility due to the transfer of assets under WAC 182-513-1363
(b) Not have equity interest in a primary residence greater than the home equity standard under WAC 182-513-1350
(c) Disclose to the agency or its designee any interest the applicant or spouse has in an annuity, which must meet annuity requirements under chapter 182-516
(3) A person who receives SSI must submit a signed health care coverage application form attesting to the provisions under subsection (2) of this section. A signed and completed eligibility review for LTC benefits can be accepted for people receiving SSI who are applying for long-term care services.
(4) To be eligible for HCB waiver services, a person must also meet the program requirements under:
(b) WAC 182-515-1510 through 182-515-1514 for DDA HCB waivers.
[Statutory Authority: RCW 41.05.021
, P.L. 111-148, 42 C.F.R. §§ 431, 435, and 457, and 45 C.F.R. § 155. WSR 17-03-116, § 182-513-1316, filed 1/17/17, effective 2/17/17.]