806-3 A   Renewals based on SNAP eligibility 

Alaska is currently approved for a Medicaid waiver that allows DPA to renew MAGI Medicaid when the SNAP recertification is approved. Although staff already do this as explained in 806-3, this waiver allows DPA to renew MAGI Medicaid eligibility for 12 months using the gross income calculated for the SNAP recertification.  This means that staff do not have to apply the special MAGI income counting rules, including tax filing or tax dependency status, and do not have to verify any Medicaid specific eligibility requirements such as development of income. In order to apply this waiver, the household must:

Not be receiving SSI ; Be part of the SNAP household.  To be considered part of a

SNAP household, a member’s needs and income must be taken into account when determining eligibility.  The household must be receiving a benefit.

Disqualified.  A disqualified member has their income counted as part of the household and has their income considered when determining the household’s eligibility for SNAP.  The household’s MAGI case can be renewed based on information in the SNAP case.

Excluded.  An excluded individual’s needs are not considered when determining SNAP eligibility or benefit amount for the household.  Some examples are ineligible students or drug felons.  Because the individual is not part of the SNAP household, this household cannot have their MAGI renewed based on information on their SNAP case.

Categorically Eligible.  If a household is eligible for SNAP benefits, but not receiving a benefit, this household cannot have their MAGI Medicaid case renewed based on SNAP information; and

Have gross income at or below the MAGI income standard. 

If the household meets the above requirements, the MAGI Medicaid case is certified for 1 year from the date of the last SNAP recertification date.  If gross SNAP income is above the MAGI standard, we cannot close the case.  In that situation, we must act on the reported change by following up with the household.

 

Example – MAGI Renewed:

Jennifer and her 2 children are receiving SNAP benefits and Medicaid.  Her SNAP recertification is received in October 2016 for November benefits.  She reports earnings of $2000 per month from a job at Walmart and child support of $200 per month. Countable gross income for SNAP is $2,200.  The income limit for MAGI for the parent/caretaker group for a household size of 3 is $2,904 and the children’s income limit is $4,250.  Jennifer and her children are given a new certification period of 11/1/15-10/31/16 for their MAGI Medicaid.

 

Example – MAGI Not Renewed - SSI

Herman and his daughter are receiving SNAP benefits and MAGI Medicaid.  The SNAP certification is received in October 2016 for November benefits.  Herman reports he has unemployment income of $1,000 per month.  His daughter receives SSI of $300 per month.  The MAGI Medicaid cannot be renewed using SNAP income information.  However, the renewal form is used to determine continued eligibility for Medicaid.

 

Example – MAGI Not Renewed – HH Member Disqualified from SNAP benefits

Lisa, her husband, Joe, and their 3 children receive SNAP benefits and MAGI Medicaid.  Joe is disqualified from SNAP benefits due to a drug felony committed in 2007.The MAGI Medicaid cannot be renewed using SNAP benefits income information.  However, the renewal form is used to determine continued eligibility for Medicaid.

 

Example – MAGI Renewed – HH Member Excluded from SNAP benefits

Marisol and her boyfriend, George, are receiving SNAP benefits and MAGI Medicaid.  George is not included in the SNAP case because he is an ineligible student.  The information on the SNAP case cannot be used to renew MAGI Medicaid eligibility.

 

Example – MAGI Not Renewed – Over MAGI Income Limit

Joe and his girlfriend, Sue, and their daughter are receiving SNAP benefits and MAGI Medicaid.  Their 10/2016 SNAP recertification reports Joe got a new job.  His gross income is $2,000 per month.  Sue has unemployment of $1,000 per month.  The gross income for the SNAP case is $3,000.  This is over the MAGI income limit.  The MAGI case is not renewed. The local office must contact Joe to verify his new income before making any change to the MAGI case.

 

808-4 D.   ALIENS EXEMPT FROM THE FIVE YEAR WAITING PERIOD 

The following qualified aliens are exempt from the five year waiting period for Medicaid, even if the exempt alien status changes.

Example:

Alex arrived in the U.S. as a refugee and is exempt from the five year waiting period. A year later, he becomes a lawful permanent resident. Even though Alex has had a change in his alien status, he is still exempt from the five-year waiting period.

 1. Refugees under Section 207 of the INA.

 2. Asylees under Section 208 of INA.

 3. Aliens whose deportation has been withheld under Section

243(h) of the INA or whose removal was withheld under section 241(b)(3) of the INA. 

4. Cuban and Haitian entrants under the Cuban-Haitian Entrant Program. 

5. Aliens admitted to the U.S. as an Amerasian immigrant. 

6. Qualified aliens who are honorably discharged U.S. military veterans, active-duty military, and their spouses (including a surviving spouse who has not remarried), and unmarried dependent children (including dependent stepchildren).

 

Note:  

Hmong and other Highland Lao tribal people who fought on behalf of the Armed Forces of the United States during the Vietnam conflict and who have been lawfully admitted to the U.S. as permanent residents are considered veterans exempt from the five year waiting period under this paragraph.

 7. Victims of trafficking under section 107 (b)(1) of the Trafficking

Victims Protection Act of 2000 (including certain family members of victims of a severe form of trafficking). 

8. Legal permanent residents who first entered the country under an exempt category (i.e. as a refugee, asylee, Cuban or Haitian entrant, trafficking victim, or alien whose deportation was being withheld) and who later converted to legal permanent resident status. 

9. Members of a federally recognized Indian tribe, as defined in 25 U.S.C. 450b(e). 

10.American Indians born in Canada under 289 of the Immigration and National Act. 

11.Special immigrants from Iraq and Afghanistan admitted under section 101(a)(27) of the INA.

813 D.       EXEMPTIONS FOR APPLYING FOR UIB  

To qualify for UIB, an individual must be available to accept employment. DPA considers the following individuals generally not available to accept employment and, therefore, they are not required to apply for UIB:

 Caretaker Of Baby:  This is a parent/caretaker relative with one or more children under the age three.

 

Note:

This exemption is only available to families with a single caretaker relative or two-parent family where at least one parent is physically or mentally incapable of performing gainful activity. It is not available to two-parent families in which both adults are physically and mentally able to perform gainful activity.

 Caretaker Of Disabled Child:  This is a parent/caretaker relative who is providing home care for a child with a disability.  This exemption must be documented by a physician or other licensed medical professional. Caretaker Of Disabled Adult:  This is a parent/caretaker relative who is providing home care to a related disabled person requiring 24 hour care. This exemption must be documented by a physician or other licensed medical professional. Medical Reason:  This is an individual who is unable to work for medical reasons, as evidenced by (a) being a recipient of SSI, APA, or SSDI; or (b) a physician or other licensed medical professional has documented that the individual is unable to work or pursue employment for medical reasons. The ET may waive the medical verification and accept client statement if the ET believes

 1. There is other evidence to indicate the person would not be

able to work for medical reasons; and 

2. The individual lives in a remote location and is not likely to have access to a physician or other licensed medical professional within 30 days after receipt of the individual’s identifiable application.

 Inappropriate Child Care:  This applies when a parent/caretaker relative who lives at home with a child under the age of six demonstrates an inability to find necessary child care because appropriate child care is not available. Child care is considered appropriate when:

 1.   A provider who is willing to take care of the parent/caretaker

relative’s child appears to have the ability to care for children of the same age and development level as the caretaker relative’s children; and 

2.   The provider’s location is within 30 minutes travel time by public or private transportation from the parent/caretaker relative’s home or work site.

 Child care is considered available when:

 1.  It is located in the family’s community; and

 2.  The family has sufficient income, or access to a child care subsidy

program, to pay the cost. 

If necessary, contact the child care local administrator or resource and referral agency for assistance with this determination.

 Under Age 16:  A child under age 16 is exempt from applying for UIB. Full-Time Student:  This is an individual who is

 1. Age 16 or older and attending, full-time, an elementary or

secondary school, vocational or technical training program which leads to a high school diploma or GED; school includes a correspondence study or GED program, or 

2. A student in a post-secondary vocational school, technical school, college, or university who attends full-time as defined by that educational institution.

 Pregnant Woman:  This is a woman in the second or third trimester of a medically verified pregnancy as verified by a physician, physician assistant, or advanced nurse practitioner, public health nurse, or community health aid or is in the 60 day postpartum recuperation period. Self-Employed: An individual who is already self-employed may be exempt. To qualify for an exemption, the individual must be: 

1. Working a monthly average of 30 hours or more per week; 

2. Receiving monthly adjusted gross self-employment income that is equal to or greater than the State of Alaska's minimum wage; and

 3. Receiving their adjusted gross self-employment income at

least once per month.

For self-employed individuals, adjusted gross self-employment earnings

actually received, or expected to be received, in a month are used to determine the self-employed individual’s hourly rate of pay.   

Note:  

The minimum wage standards can be found at: http://labor.alaska.gov/lss/whact.htm

The individual's adjusted gross self-employment income must meet or exceed these income standards to be exempt from the pursuit of unemployment income. See section 821 for additional information on self-employment income.

 Part Time Employment:  The same weekly income standard of 30 hours per week at the State of Alaska’s minimum wage can be applied to individuals who are working for an employer on a part-time basis and receiving regular earnings.  Vista Volunteer:  This is an individual who is a full-time VISTA volunteer.

 815           RESIDENTS OF INSTITUTIONS 815 A.      DEFINITIONS 

Inmate:  An individual who is living in a public institution, which is not defined as a medical institution. Inpatient:  A patient who has been admitted to a medical institution and who:

 1.  receives room, board and professional services in the institution for a 24 hour period or longer, or  2.  is expected by the institution to receive room, board and

professional services in the institution for a 24-hour period or longer even if the patient dies, is discharged, or is transferred to another facility before 24 hours have elapsed.

 Medical Institution:  An institution certified under state law to provide medical care, including nursing and convalescent care, such as a hospital, skilled nursing facility (SNF), intermediate care facility (ICF), intermediate care facility for the Intellectually Developmentally Disabled (ICF-IDD), residential psychiatric treatment center ( RPTC ); and an assisted living home that provides residential supported living or habilitation services, such as Alaska Pioneers’ Homes.  

 Penal Institution:  A correctional or holding facility for individuals who are held as prisoners (e.g. prison or jail), such as the Fairbanks Youth Facility. Public Institution:  A facility including a penal institution that is the responsibility of a governmental unit or over which a governmental unit exercises administrative control.  A medical institution is not a public institution even if it is administered by a governmental unit.  

  815 B.       MEDICAL INSTITUTION 

Medicaid eligibility may be available to an individual residing in a medical institution if all eligibility criteria are met.   An individual age 21 receiving active treatment in a medical institution, such as in Alaska Psychiatric Institute (API), may be Medicaid eligible providing they have continuously resided in an inpatient psychiatric hospital since being determined Medicaid eligible.  Eligibility ends the month of his or her 22nd birthday or discharge from the facility, whichever occurs first.

    815 C.       PUBLIC INSTITUTION

 An individual residing in a public institution, regardless of whether the placement was voluntary or involuntary, is not eligible for Medicaid.  

  815 D.       PENAL INSTITUTION 

An individual incarcerated in a penal institution, including a juvenile committed by the court to a correctional facility, may be eligible for Medicaid while the individual is an inmate, however; covered services are suspended.  The inmate status continues until the individual is released on parole, or is pardoned.  An individual is still considered an inmate if he or she: 

1.  Leaves a correctional facility but continues to be in DOC custody; or

2.  Leaves a correctional facility for treatment in an acute care medical facility; or

3.  Is a child who is temporarily sent to an evaluation or diagnostic center for a determination of the most appropriate institutional

placement resulting from a court order for commitment under the penal system?

 An individual living outside a correctional facility serving a period of temporary commitment by electronic monitoring is not considered incarcerated in a penal institution. Most medical care for adults (including juveniles waived to adult status) who are incarcerated by the state is provided through the Department of Corrections (DOC).  A juvenile in a correctional facility receives most medical care through the Division of Juvenile Justice (DJJ ).   1.  Incarceration and Medicaid Even though incarcerated individuals may continue to meet all other eligibility requirements, Medicaid will not pay for medical claims while the individual is incarcerated, with one exception.   Incarcerated adults and children who are Medicaid eligible and have been admitted to a hospital for more than 24 hours may have the medical charges paid by Medicaid.   All of the eligibility requirements for Medicaid must still be met to receive this coverage. If an incarcerated individual no longer meets all eligibility factors, his or her case will be closed or denied with adequate notice. 

Applications: 

The hospital will assist the incarcerated individual with completing an application if the individual is not already receiving Medicaid.  If eligible, the Medicaid case will be authorized for 12 months, using the correct incarceration subtype. The Medicaid case will close at the end of the certification period unless it has been reported that the individual is no longer incarcerated.    

Example:

Noah is incarcerated and does not have on-going Medicaid. On 11/26/2016.he becomes ill and is admitted to the hospital for more than 24 hours. He turns in a Medicaid application on 11/30/16 and is determined eligible for Medicaid from 11/01/2016 – 10/31/2017 with the appropriate incarcerated subtype.

 On-going Medicaid:

 When it has been reported that a recipient is incarcerated, the Medicaid subtype must be changed to the ‘incarcerated’ subtype for the month following the report of incarceration.  If the individual is on

a case with other household members, the individual must be removed from the case and treated as an applicant.  The first case with the other household members must be processed accordingly due to the report of change.

 Example:

Davi, his spouse, and children are together on an on-going Medicaid case. Davi is reported incarcerated by his spouse on 06/03/16. Davi is coded out of his family’s Medicaid case starting 07/01/2016. Davi is determined eligible for incarcerated Medicaid on a new case by himself. His certification period is 07/01/16-06/30/2017. The Medicaid case with the other household members is processed accordingly with the household size report of change.

Applications for OCS Title IV-E children in DJJ custody will continue to be processed by OCS in EIS.    Applications for children in DJJ custody and adults in DOC custody will be processed by the Field Services Support Unit.  In some instances, a child is released from a correctional facility into a medical institution, treatment facility, or community setting permanently or indefinitely, but the child remains in DJJ custody.  In such a case, the child may become eligible for Medicaid beginning in the first month in which the child is out of the correctional facility for at least one full day.  After making a prospective eligibility determination, an ET may authorize eligibility for the child up to three working days prior to the release date, provided the release date is verified by DJJ.  To verify the release date, the ET must contact (in the order given) one of the following individuals: The Youth Corrections Operations Manager at (907) 261-4335;The State Office Juvenile Probation Officer at (907) 465-2212;The OCS Medicaid Coordinator at (907) 465-3633.  

815 E.       SUBSTANCE ABUSE TREATMENT FACILITIES AND HALFWAY HOUSES

 Medicaid eligibility may be available to an individual who is not in the custody of the state, but who is residing in a halfway house. Halfway houses reserve a small number of beds for individuals on probation or parole that may be ordered to live in a structured environment as a condition of their supervision.

An individual living at a halfway house may or may not still be in custody of DOC. If there is confusion on the part of an individual about his or her custody, verify the individual's status with the appropriate agency.   An individual receiving active treatment in a community substance abuse program may also qualify for Medicaid coverage if the individual meets all eligibility criteria; however, Medicaid does not cover the cost of the treatment in the facility.

  815 F.       PARTIAL MONTH STATUS

 Medicaid payments are available for services received by an otherwise eligible applicant during the first and last partial months of residence in a public facility because he or she resided outside the facility for part of each month.

Example:

Emma applies for Medicaid on 07/03/16. When processing the application, the ET discovers that Emma became incarcerated on 07/09/16 with an unknown release date. She meets all other eligibility factors. As Emma was not incarcerated for the entire month of 07/16, she is eligible for regular Medicaid benefits for 07/16. The appropriate incarcerated Medicaid subtype will be used starting 08/16.

817-1   CONSTRUCT A MAGI HOUSEHOLD FOR EACH INDIVIDUAL 

MAGI Medicaid household household composition for each individual is determined using tax filing rules.   The household size of a pregnant woman also includes the unborn child or children expected.  The unborn child does not count in the household size of the other members.  The needs and income of the father of the unborn child are not included in this determination unless he is part of the tax filing household.

Usually the tax household consists of parents and their dependent children (biological, adopted, or step); however, IRS rules allow that tax dependents can also be qualifying relatives and even non-relatives. Extended family members and unrelated individuals claimed as tax dependents can be in the same MAGI Medicaid household. Non-relative

dependents may count for household size, but may not be covered by Medicaid unless they meet one of the available categories. Use the following chart to determine each individual's household composition.  The individual's household composition will determine whose income in the household is included for the individual's MAGI Medicaid eligibility determination.  

 A.    Tax Filer Rules: The following people are included in the household size if

the tax filer is not also claimed as someone else’s dependent:

  Tax filer; Tax filer's spouse, if living with tax filer or filing

jointly; and Any individual reasonably established to be a tax

dependent of the tax filer. 

B.    Tax Dependent Rules: The following people are included in the household size of

the tax dependent:  Tax dependent; Tax filer that claimed the dependent; Tax filer’s spouse, if living with the tax filer or filing

jointly; Tax dependent’s spouse, if living with the tax

dependent or filing jointly; and Any individual reasonably established to be a tax

dependent of the tax filer. C.    Non-Tax Filer Rules: A household size is determined by the Non-Filer Rule if any

of the following are true: 

Individual is a tax dependent who is not the tax filer’s spouse or the tax filer’s child;

Individual is a tax dependent child who lives with both parents that do not file jointly and has been claimed as a tax dependent by 1 parent; or

Individual is a tax dependent child who expects to be claimed by a non-custodial parent.

 If an individual is a Non-Filer, the following household size is

established: 

Individual; Individual’s (biological, adoptive, or step) parents, if

living with the individual; Individual’s (biological, adoptive, half or step) siblings

(age <19), if living with the individual; and, Individual’s spouse, if living with individual.

818                INCOME FOR MAGI MEDICAID  

Countable income for MAGI Medicaid is determined following IRS rules for countable income and deductions with some exceptions.  MAGI is the household's AGI, or Adjusted Gross Income with the addition of the following:  tax-exempt interest, Social Security benefits not included in the gross income, and excluded foreign income. Once the individual's MAGI Medicaid household has been determined using the chart in section 817-1, DPA can determine the total MAGI Medicaid income for the individual.   The countable income of the individual and individual's household members determine the total countable income for the individual. 

Note:

Income for a tax dependent of any age does not count for the household unless it is over the tax filing threshold. Even if the tax dependent chooses to file taxes, if their income is under the threshold it is not counted for MAGI Medicaid. In 2016, the tax filing threshold for tax dependents is $6300 per year for earned income, $1050 per year for unearned income, or a combination totaling over $5950 earned plus $350 unearned.

  

1. Add all taxable income (such as wages, self-employment, interest, dividends, rental and royalty income, capital gains, unemployment, alimony, etc.),

2.  Add the non-taxable social security benefits, foreign income, and tax exempt interest (such as employee savings bonds) into the calculation, and

3.  Subtract allowable tax deductions (such as moving expenses, alimony paid, etc.)

 4.  The result is the total MAGI Medicaid income for the individual. 

Reference Addendum 3 to determine if income types are countable for MAGI Medicaid.  Reference Addendum 4 for MAGI Income deductions.

819      TYPES OF INCOME While there are many sources of income, all income is separated into two types for MAGI Medicaid purposes: earned and unearned.  Refer to sections 819 A and 819 B for explanations of earned and unearned income.

Refer to Addendum 3 to determine if the income is countable for MAGI Medicaid.   

819 C. RENTAL INCOME 

Rental income may be either earned or unearned income. Rental income is treated as self-employment income when the owner of real or personal property performs the managerial responsibilities, earning the income by his or her own efforts.  When rental income is treated as self-employment income, allowable costs of doing business are deducted from gross rent receipts to determine adjusted gross self-employment income.  

Rental income is treated as unearned income when the owner of real or personal property does not perform the managerial responsibilities for the rental property.  When rental income is treated as unearned income, the countable unearned income is the amount of rent paid by the renter less any property management fees incurred.

Note:    

Income received from the lease of a limited entry fishing permit or fishing vessel is considered unearned rental income. If the income is received as a lump sum payment, budget the income over the months the fishing permit or vessel is being used. 

833 a.  Eligibility The approved hospital is making the eligibility determination using simplified MAGI Medicaid rules for the presumptive eligibility period. DPA is authorizing the Medicaid benefits based on the hospital's determination.  The presumptive eligibility period begins the date that the hospital determines the applicant presumptively eligible for Medicaid and ends the earlier of: 

1. The date the ineligibility determination for regular MAGI Medicaid is made, if a full application for MAGI Medicaid is filed by the end of the month after the month that presumptive eligibility is determined; or

 2. The last day of the month after the month of the HPE Medicaid determination, if a full application for Medicaid is not filed by that date.

 An individual can only have one hospital presumptive eligibility approval within a 12 month period, starting with the month of the initial HPE period. A pregnant woman can be found presumptively eligible once per pregnancy, even if the pregnancies occur within the same 12 month period. 

Example 1:

An individual received HPE benefits on 9/8/15. The 12-month period for this client is 9/2015 – 8/2016 so the client is eligible for HPE benefits again 9/1/2016.

Example 2:

A pregnant woman received HPE coverage starting 09/08/2015. The pregnancy ended, and she becomes pregnant again on 07/02/2016. As it is a second pregnancy, she is eligible for another HPE period, even though it has not been a year since the initial HPE period.

Example 3:

A woman received HPE coverage for Expansion Medicaid starting 09/08/2015. She becomes pregnant and applies for HPE coverage on 01/05/2016. As the initial HPE period was not for Pregnant Woman Medicaid and it has not been 12 months since the approval, she is not eligible for HPE coverage from the 01/05/2016 application.

A qualified hospital is one that participates as a provider under the Medicaid state plan and has notified the Medicaid agency of its election to make presumptive eligibility determinations and agrees to make presumptive eligibility determinations consistent with state policies and procedures. A qualified hospital must help individuals complete a full Medicaid application.  The current list of qualified hospitals approved to make hospital presumptive eligibility determinations can be found on the DPAweb under ET Resources, titled "Approved Hospital List (HPE)." If any approval paperwork is received from a hospital not on this list or the hospital presumptive eligibility determination is signed by a hospital worker not listed, please contact the Policy & Program Development Team at dpapolicy@alaska.gov. A state may disqualify a hospital from conducting presumptive eligibility determinations if the state finds that the hospital is not making or is not capable of making accurate presumptive eligibility determinations in accordance with applicable state policies and procedures.

Addendum 1

MAGI Medicaid Income StandardsEffective April 1, 2017

   

Parents and Caretaker Relatives and Under 21 *These income standards are updated each year on January 1st

 Household Size Monthly Income Limit

1 1,4872 2,3703 2,9044 3,4375 3,9726 4,5057 5,0388 5,5719 6,105

10 6,638Each additional person 534

    

Expansion Group*These income standards are updated each year on April 1st

 Household Size Monthly Income Limit

1 1,6702 2,2493 2,8294 3,4095 3,9886 4,5687 5,1488 5,7279 6,307

10 6,887Each additional person 580

   

  

Pregnant Women*These income standards are updated each year on April 1st

 Household Size Monthly Income Limit

1 n/a2 3,3823 4,2544 5,1255 5,9976 6,8697 7,7408 8,6129 9,484

10 10,356Each additional person 872

     

Children Under Age 19 With Insurance*These income standards are updated each year on April 1st

 Household Size Monthly Income Limit

1 2,2222 2,9933 3,7654 4,5365 5,3086 6,0797 6,8508 7,6229 8,394

10 9,166Each additional person 772

  

                                                                                

Children Under Age 19 Without Insurance

*These income standards are updated each year on April 1st 

Household Size Monthly Income Limit1 2,5482 3,4333 4,3184 5,2025 6,0876 6,9727 7,8578 8,7419 9,626

10 10,511Each additional person 885

    

MAGI Income Disregards - 5% of the Federal Poverty Level*These income disregards are updated each year on April 1st

  Household Size Disregard

1 632 853 1074 1295 1506 1727 1948 2169 23810 260

Each additional person 22

Addendum 3Countable and Excluded income for MAGI Medicaid

 *If an individual has a Medicaid Income Qualifying Trust (Miller Trust) or Special Needs Trust,

please follow ADLTC manual section 528.

 *A tax dependent's countable income under the tax filing threshold is not countable.  See section

818. 

This chart is not comprehensive.  For questions regarding income types, please e-mail dpapolicy@alaska.gov.

 

Type of income Countable for MAGI Medicaid?Adoption payments, subsidized NoAdult Pubic Assistance (APA) NoAmerican Indian/Alaska Native payments:

1) Distributions from Alaska Native Corporations and Settlements Trusts (ANSCA);

2) Distributions from any property held in trust located within the most recent boundaries of a proper Federal reservation;

3) Distributions and payments from rents, leases, rights of way, royalties, usage rights, or natural resource extraction and harvest;

4) Distributions resulting from real property ownership interests relation to natural

resources and improvements;5) Payments resulting from ownership

interests in or usage rights to items that have unique religious, spiritual, traditional, or cultural significance or rights that support subsistence or a traditional lifestyle according to applicable Tribal Law or custom;

6) Student financial assistance provided under the Bureau of Indian Affairs education Programs;

7) Settlement payments resulting from the Cobell v. Salazar class action lawsuit.

No

Annuities (recurring payments received from investments)

Yes

Alaska Temporary Assistance Program payments, including supportive payments

No

Alien Sponsor income YesChild Support NoCompensatory payments, court ordered NoContractual Income, such as monthly payments Yes

from sale of a houseContract Work Yes, Individuals who are employed under a

contract and are not paid for their contractualwork on at least a monthly basis will have their earnings prorated over the numberof months covered by the income. However, any draws or wages received in advanceof the contractual earnings are treated as earned income in the month of receipt.

The months covered by the contractual income are the months in which the employeeis actually working under the terms of the contract.

Corporation For National and Community Service (CNCS) payments, which include AmeriCorps, VISTA, National and Civilian Corp, Foster Grandparents, the Senior Companion Program, and Retired and Senior Volunteer Corps (RSVP)

Yes(*AmeriCorps award at end of service is not countable if it goes directly to an educational institution.)

Corporation income from partnerships, estates, and S-corporations

Yes

Disaster and Emergency Assistance provided by states, local governments, or disaster assistance organizations

No

Earned Income Tax Credit (EITC) NoEducational Grants, Awards, and Loans issued under any program funded under the Title IV of the Higher Education Act or under a Bureau of Indian Affairs student assistance program

No

*amount used for living expenses is countable

Employer Sponsored Occupational Disability payments

No

Energy Employees Occupational Illness Compensation

No

Estate Income YesFlexible Health benefits If the employer pays flexible health benefits on

behalf of the employee and the employee must use this money to purchase health insurance, only the amount that goes directly to the employee (benefit contribution excess) is counted when determining a household'sgross income. Any amount that the employer pays for mandatory health insurance benefitsthat the employee does not receive in addition to their regular pay is not counted as income to the employee.

Food Stamps, including Food Stamp Hold harmless payment

No

Foster Care, including Therapeutic Foster Care and boarding home payments

No

Garnishments YesGeneral Assistance (GA) NoGifts NoGuardianship payments, subsidized NoHeating Assistance, direct payments to households and vendors

No

Inheritances NoIn-kind earned income received as compensation for services rendered, such as rent reduction in exchange for managing apartments

Yes

In-kind support and maintenance not in the form of money such as meals, clothing, or housing

No

Interim Assistance NoJury Duty payments and Witness fees YesJury Duty Reimbursements and per diem NoLoans, including educational, personal, and commercial

No

Lump sum payments, non-recurring Yes, counted only in the month receivedMAAST (Mature Alaskans Seeking Training Skills) YesMilitary wages Yes (see Addendum 6 for further information)PASS I, II, III Childcare NoPayee Arrangements when an individual is acting as a formal or informal agent, trustee, payee, or financial guardian for another person. A client who cashes a severely disabled relative's assistance checks and spends thecash to meet that person's needs;An urban client who occasional receives cash or a money order from a friend who livesin a remote area and needs an intermediary to purchase supplies on his behalf;A client who has been given signature authority on an institutionalized relative'sbank account; orA client accepts a roommate's share of the rent and passes it on to their landlord.Such arrangements may involve a joint bank account, signature authority, depositsof the non-client's funds into a singly held account, or simply a hand or mail transferof cash.

No, These funds will not count as MAGI Medicaid available income, to the extent thatthe client can demonstrate that he or she merely passes through the monies, and thatthey are not used for support of the household. Prudent judgment will be requiredin determining whether all or part of such monies can be exempted, as the often-informalnature of many payee arrangements makes documentary proof hard to obtain.

Per Diem payment from employment No

Permanent Fund Dividends Yes, PFD payments will be annualized. The amount used should be the amount of the last year’s PFD until the current year’s PFD is officially announced by the DPA Policy Unit.

Punitive Payments, court ordered YesRefugee Assistance, paid one time or monthly NoRecoupments NoReimbursements NoRelocation payments NoRental allowance for clergy persons/Parsonage Allowance

No

Rental income, including room rental YesRetirement/pension income YesRestitution made to Aleuts or individuals of Japanese ancestry under Public Law 100-383

No

Self-employment income Yes (see MS 821 for more information)

Exception: Self-employment income from fishing is exempt income for tribal members from and living in Metlakatla

Senior Benefits NoSocial Security Income (SSI) Not countable for a child or the household

member that claims the recipient as a tax dependent. Countable only to the adult who receives it.

Social Security payments, excluding SSI. These include Disability, Retirement, Widower’s, and Survivor’s payments

Yes. For child tax dependents, amount is only countable if child’s income is above the tax filing threshold

Spousal Support (Alimony) YesTax returns, federal, NoTax returns, state YesTrust income YesUnemployment benefits (UIB) YesVendor payments – money paid by an outside sourced to a third party on behalf of the household

No

Veterans Disability payments to primary individual or survivor, include VA dependency and indemnity payments

No

Veterans retirement paid by the Department of Defense Finance and Accounting Services (DFAS)

Yes

Veterans Survivor benefits YesVictims of Crime Compensation NoVocational Rehabilitation from a state or Veteran program

No

Wages, including salaries, bonuses, commissions, tips, overtime, severance, and gratuities. This

Yes

includes an SSI recipient’s wages.Worker’s Compensation NoWorkforce Investment Act (WIA), such as the Summer Youth Employment and Training Program

Taxable wages are countable. Living allowances are not.

Work Study No

*If an individual has a Medicaid Income Qualifying (MIQ) Trust (Miller’s Trust), please follow ADLTC manual section 528.