Long-term care eligibility (institutional medical)

Revised April 25, 2013

Eligibility requirements

• Application processes for long-term care eligibility
• Eligibility Requirements  (Institutional roadmap WAC)
• Institutional Status  (In ACES K track (children and families) and L track Aged/Blind/Disabled )
• Citizenship and Alien Status Requirements for all programs.
• Exception to rule (ETR) process for HCS cases where we are unable to verify citizenship and ID.
• Medically Needy  (Specific rules are used for Medical Needy in a Medical Institution for gross income over the Medicaid SIL ) (L95, L99)
• Long-term care services in a nursing home (L04) or community setting (L24) for non-citizens  
• Long term care for families and children (K01, K95, K99)
• State funded HCS services (G01 in residential settings) and other state funded services
• Home and Community Based Waivers and Hospice (L21, L22)
• 1619B and SSI deemed eligibles (after DAC, Pickle/COLA, Widower Exclusion)