WAC 182-505-0245 Income and resource standards for family medical programs.

1. The categorically needy income level (CNIL) standards for family medical are:

   a. For assistance units with obligations to pay shelter costs:

b. For assistance units with shelter provided at no cost:

2.   The countable resource standards for family medical are the same as those of the 

       TANF/SFA cash program as stated in WAC 388-470-0005. 

3.   Each unborn child is counted as a household member when determining household size for:

a.  Family medical;

b.  Pregnancy medical; and

c.   Children's medical

WAC 182-519-0050 Monthly income and countable resource standards for medically needy (MN).

1. Changes to the Medically Needy Income Level (MNIL) occur on January 1st of each calendar year when the Social Security Administration (SSA) issues a cost-of-living adjustment for that year.
   
2. Medically Needy (MN) standards for persons who meet institutional status requirements are in WAC 388-513-1395.  The standard for a client who lives in an alternate living facility can be found in WAC 388-513-1305.

3. The resource standards for institutional programs are found in WAC 388-513-1350.  The institutional standard chart can be found at http://www.dshs.wa.gov/manuals/eaz/sections/LongTermCare/LTCstandardspna.shtml. 

4. Countable resource standards for the noninstitutional MN program are:

   1. One person $2,000.

   2. Two persons $3,000.

   3. For each additional family member add $50.

5. For individuals who do not meet institutional status requirements, the income standard used to determine eligibility for the medically needy program is the "effective" MNIL.  The "effective" MNIL is the one-person federal benefit rate (FBR) established by SSA each year, or the MNIL listed below, whichever amount is higher.  The FBR is the supplemental security income (SSI) payment standard.  For example, in 2012 the FBR is six hundred ninety-eight dollars.

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WAC 182-505-0100 Medical programs-- Monthly income standards based on the federal poverty level (FPL).

1. Each year, the federal government publishes new federal poverty level (FPL) income standards in the Federal Register found at http://aspe.hhs.gov/poverty/index.shtml. The income standards for the following medical programs change on the first of April every year based on the new FPL:

   1. Pregnant women's program up to one hundred eighty-five percent of FPL.

   2. A program included in apple health for kids up to two hundred percent of FPL.

   3. Healthcare for workers with disabilities (HWD) up to two hundred twenty percent of FPL.

   4. Premium-based coverage under a program included in apple health for kids over two hundred percent of FPL, but not over three hundred percent of FPL.

2. The department uses the FPL income standards to determine:

   1. The mandatory or optional Medicaid status of an individual.

   2. Premium amount, if any, for a child.

3. There are no resource limits for the programs under this section.

WAC 182-512-0010 Supplemental Security Income (SSI) standards; SSI-related categorically needy income level (CNIL); and countable resource standards.

1.  SSI payment standards, also known as the federal benefit rate (FBR), change each January 1.

2.  See WAC 388-478-0055 for the amount of the state supplemental payments (SSP) for SSI recipients.

3.  See WAC 388-513-1305  for standards of clients living in an alternate living facility.  

4.  The SSI-related CNIL [Categorically Needy Income Level] standards are the same as the SSI payment standards for single persons and couples.  Those paying out shelter costs have a higher standard than people who have supplied shelter.

5.  The countable resource standards for SSI and SSI-related CN medical programs are:

a. One person $2,000.

b. A legally married couple $3,000.

WAC 182-517-0100 Medicare savings programs--Monthly income standards.

1. The income standards for Medicare Savings Programs change each year based on the federal poverty level (FPL) published yearly by the federal government in the Federal Register at http://aspe.hhs.gov/poverty/index.shtml. The qualified Medicare beneficiary (QMB) program income standard is up to one hundred percent of the federal poverty level (FPL).

2. The specified low-income Medicare beneficiary (SLMB) program income standard is over one hundred percent of FPL, but not more than one hundred twenty percent of FPL.

3. The qualified individual (QI-1) program income standard is over one hundred percent of FPL, but not more than one hundred thirty-five percent of FPL.  

4. The qualified disabled working individual (QDWI) program income standard is two hundred percent of FPL .