Current through August 30, 2024
(a) Except as
otherwise provided in this section, to be eligible for Medicaid, a member of a
household who may be eligible for benefits under one or more of the following
programs must apply for and, if eligible, accept benefits from that program:
(1) workers' compensation under AS
23.30;
(2) social security
disability, old-age, or survivor's benefits under
42 U.S.C.
401-
434;
(3) United States Department of Veterans
Affairs benefits under 38
U.S.C. 101-
8528;
(4) civil service disability and retirement
under 5 U.S.C.
8101-
9009;
(5) railroad disability and retirement under
4 5 U.S.C.
231-
231e ;
(6) government or private retirement
programs;
(7) unemployment
insurance benefits under
AS
23.20.330-23.20.405.
(b) An applicant or recipient is not required
to apply for benefits from the following programs to be eligible for Medicaid:
(1) supplemental security income (SSI) under
42 U.S.C.
1381-
1383f;
(2) United States Department of Interior,
Bureau of Indian Affairs general assistance under 2
5 U.S.C.
13 d-1-
13d-3 ;
(3) any other assistance program administered
by the department.
(c)
The department will screen each applicant's or recipient's application for
potential eligibility for one or more of the programs identified in (a) of this
section and, if potential eligibility is identified, notify the applicant or
recipient that the applicant or recipient must apply for that program. In the
notice, the department will inform the applicant or recipient that if the
applicant or recipient fails to apply for and, if found eligible, accept a
benefit from that program within the time frame identified in (d) or (e) of
this section, whichever is applicable,
(1)
the entire household will become ineligible for Medicaid benefits if the
applicant or recipient is a mandatory member of the household under
7 AAC 100.104; or
(2) the applicant or recipient, and the
applicant's or recipient's spouse, will become ineligible for Medicaid benefits
if the applicant or recipient is not a mandatory member of the
household.
(d) Except as
provided in (e) of this section for unemployment insurance benefits, if, after
receiving a notice under (c) of this section, and without good cause under (h)
of this section, an applicant or recipient fails to apply for or, if eligible,
accept any benefits from a program listed in (a) of this section within 30 days
after the date on the notice, the department will take action under (f) of this
section.
(e) If, after receiving a
notice under (c) of this section, and without good cause under (h) of this
section, an applicant or recipient fails to apply for or, if eligible, accept
any unemployment insurance benefits within 10 days after the date on the
notice, the department will take action under (f) of this section.
(f) If, after the time period specified in
(d) or (e) of this section, and without good cause under (h) of this section,
an applicant or recipient has failed to apply for or, if eligible, accept a
benefit described in (a) of this section, the department will notify the
applicant or recipient that Medicaid benefits will be discontinued. An
applicant or recipient has 10 days after the date notice is sent under this
subsection to comply with the requirements of this section or provide evidence
of good cause for failure to comply with those requirements.
(g) For the purposes of Medicaid eligibility
under this chapter, the following individuals are considered unavailable to
accept employment and are not required to apply for unemployment insurance
benefits:
(1) a parent or caretaker relative
who is providing care at home to a
(A) child
under the age of three;
(B) child
with a disabling condition documented by a physician, physician assistant, or
advanced nurse practitioner; or
(C)
related adult with a disabling condition who requires 24-hour care; the
disabling condition must be documented by a physician, physician assistant, or
advanced nurse practitioner;
(2) an individual who has a medical reason
for being unable to work or pursue employment; to establish that a medical
reason exists, the recipient must
(A) be a
recipient of SSI, APA, or SSDI;
(B)
have the medical reason verified by a physician, physician assistant, or
advanced nurse practitioner; or
(C)
submit other information satisfactory to the department of a medical reason, if
the applicant lives in a remote location and is unlikely to have access to a
physician, physician assistant, or advanced nurse practitioner who can verify a
medical reason under (B) of this paragraph within 30 days after the
department's receipt of an identifiable Medicaid application;
(3) a parent or caretaker relative
who
(A) lives at home with a child under six
years of age; and
(B) demonstrates
that the parent or caretaker's household does not have
(i) sufficient income to pay for appropriate
child care; or
(ii) access to child
care assistance under 7 AAC 41;
(4) a child under 16 years of age;
(5) a full-time student attending elementary
school, secondary school, post-secondary school, vocational or technical
school, or another program that leads to a high school diploma, general
education development (GED) credential, or post-secondary diploma; in this
paragraph "full-time" has the same meaning used by the education institution
being attended;
(6) a woman in her
second or third trimester of pregnancy, as verified in accordance with
7 AAC 100.124, or who is eligible for Medicaid
postpartum coverage under
7 AAC 100.304;
(7) a self-employed individual who is working
at least a monthly average of 30 hours per week and who is receiving monetary
compensation equal to or greater than the minimum wage established under
AS
23.10.065 at least once per month for the
work performed;
(8) a volunteer in
the Volunteers in Service to America (VISTA) program under
42 U.S.C.
4951-
4995.
(h) Good cause is determined by the
department and includes
(1) a weather
condition that causes a mail delay;
(2) an applicant's or recipient's lack of
transportation;
(3) an illness of
the applicant, the recipient, or a member of the applicant's or recipient's
family;
(4) an emergency in the
applicant's or recipient's family, including death in the family; and
(5) another circumstance beyond the
applicant's or recipient's control that prevents the applicant or recipient
from applying for or, if eligible, accepting a benefit described in (a) of this
section.
(i) In this
section,
(1) "apply for" means to actively
pursue the benefits of an assistance program by complying with all application
and program requirements;
(2)
"appropriate child care" means a provider
(A)
who is willing to take care of the child and who appears to have the ability to
care for children of the same age and developmental level as the parent's or
caretaker relative's child; and
(B)
whose location is within 30 minutes' travel time by public or private
transportation from the parent's or caretaker relative's home or work
site;
(3) "disabling
condition" means a condition that prevents an individual from caring for that
individual's own daily health care needs or managing that individual's own
daily affairs.
Authority:AS
47.05.010
AS
47.07.040
