Purpose: The following medical assistance countable income and resource standards are used to determine eligibility when cash assistance is not involved. See the following categories for eligibility and computation factors:
WAC 388-478-0065 Income and resource standards for family medical programs.
The categorically needy income level (CNIL) standard for family medical is the same as the grant payment standards for the TANF cash program as stated in WAC 388-478-0020.
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.
Each unborn child is counted as a household member when determining household size for:
To see the complete list of Medical Assistance Standards, please go to Medical Income and Resource Standards Chart (pdf)The resource standard for an applying family is $1000. There is no resource limit for continuing recipient families.
WAC 388-478-0070
WAC 388-478-0070
Effective May 20, 2008
WAC 388-478-0070 Monthly income and countable resource standards for medically needy (MN).
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.
Under the MN program, a person whose income is more than the MNIL can use medical expenses to reduce income. See SPENDDOWN.
Income and resource standards for long term care services are found in LONG TERM CARE.
WAC 388-478-0075
WAC 388-478-0075
Effective April 17, 2009
WAC 388-478-0075 Medical programs --Monthly income standards based on the federal poverty level (FPL).
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:
Pregnant women's program up to one hundred eighty-five percent of FPL.
A program included in apple health for kids up to two hundred percent of FPL.
Healthcare for workers with disabilities (HWD) up to two hundred twenty percent of FPL.
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.
The department uses the FPL income standards to determine:
The mandatory or optional Medicaid status of an individual.
Premium amount, if any, for a child.
There are no resource limits for the programs under this section.
An unborn or confirmed multiple unborns are counted as family members when determining family (Assistance Unit) size.
There are no resource limits for the pregnant women's and children's (CN) or HWD programs when using the FPL income standards.
If the income of an Assistance Unit exceeds the FPL standards, consider eligibility for the MN program using the MNIL income standards in WAC 388-478-0070.
When using the MNIL standards, the MN countable resource standards apply to the pregnant women's program, but no resource standards apply to the children's MN or children's health programs.
WAC 388-478-0080
WAC 388-478-0080
Effective May 20, 2008
WAC 388-478-0080 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:
WAC 388-478-0085 Medicare savings programs--Monthly income standards.
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).
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.
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.
The qualified disabled working individual (QDWI) program income standard is two hundred percent of FPL .
