Alaska Administrative Code
Title 7 - Health and Social Services
Part 7 - Medicaid Assistance Eligibility
Chapter 100 - Medicaid Eligibility
Article 8 - Medicaid Eligibility for the Aged and Disabled
7 AAC 100.426 - Working disabled Medicaid buy-in

(a) An individual with a disability who is ineligible for APA under 7 AAC 40 or APA-related Medicaid under 7 AAC 100.400 - 7 AAC 100.424 because of earned income that is either the individual's own income or the income of the individual's spouse, is eligible for Medicaid under 7 AAC 100.002(d) (6) and this section if

(b) The department will determine net family income by combining all nonexcluded income of each family member and then, using APA methodology applicable under 7 AAC 100.400, subtracting all disregards and exclusions, including impairment-related work expense exclusions under 7 AAC 40.320(a) (21). The spousal deeming provisions of 7 AAC 40.240 do not apply.

(c) When determining the unearned income of a disabled individual, the department will count the unearned income of a spouse.

(d) A disabled individual eligible under this section must pay a premium to the state as determined by the department. Premiums will be assessed on a sliding fee schedule based on the family's annual net income, and calculated using the formula set out in sec. 10, ch. 130, SLA 1998. An individual is not subject to a premium if the annual family income is below 100 percent of the federal poverty guidelines for this state, adopted by reference under 7 AAC 100.980. An individual's monthly premium may not exceed 10 percent of the disabled individual's net family income. Eligibility for Medicaid under this section will be terminated if an individual is 60 days delinquent in paying a premium.

(e) A Medicaid qualifying income trust under 7 AAC 100.610 may be used to reduce income under this section. Net family income must include any payment made from a trust to the disabled individual. A payment from a trust is unearned income. If a trust pays an individual's premium under this chapter, the payment is not income if the payment is made by the trust directly to the department.

(f) An individual may be eligible for Medicaid under this section even if the individual has not actually received APA or APA-related Medicaid under 7 AAC 100.400 - 7 AAC 100.424 before.

(g) In this section, "family" means the applicant, the applicant's spouse, and any dependent children of either the applicant or spouse who are living in the same household more than 50 percent of the time in a month. In this subsection, "dependent child" means an individual who