WAC 182-508-0005 Eligibility for medical care services.

(1)  An individual is eligible for medical care services (MCS) benefits to the extent of available funds if the individual:

(a)  Completes an interview with the agency or its designee; 

(b)  Is incapacitated as required under WAC 182-508-0010 through 182-508-0120;

(b)  Is at least eighteen years old or, if under eighteen, a member of a married couple;

(c)  Is in financial need according to MCS' income and resource rules in chapter 182-509 WAC.  The agency or the agency's designee determines who is in the individual's assistance unit according to WAC 182-506-0020;

(d)  Meets the medical care services citizenship/alien status requirements under WAC 182-503-0532;

(e)  Provides a Social Security number as required under WAC 388-476-0005;

(f) Resides in the state of Washington as required under WAC 182-503-0520;

(g)  Reports changes of circumstances as required under WAC 182-504-0100; and

(h)  Completes a mid-certification review and provides proof of any changes as required under WAC 182-504-0040.

(2)  An individual is not eligible for MCS benefits if the individual:

(a)  Is eligible for temporary assistance for needy families (TANF) benefits.

(b)  Refuses or fails to meet a TANF rule without good cause.

(c)  Refuses to or fails to cooperate in obtaining federal aid assistance without good cause.

(d)  Refuses or fails to participate in drug or alcohol treatment as required in WAC 182-508-0220.

(e)  Is eligible for Supplemental Security Income (SSI) benefits.

(f)  Is an ineligible spouse of an SSI recipient.

(g)  Refuses or fails to follow a Social Security Administration (SSA) program rule or application requirement without good cause and SSA denied or terminated the individual's benefits.

(h)  Is fleeing to avoid prosecution of, or to avoid custody or confinement for conviction of, a felony, or an attempt to commit a felony as described in WAC 182-503-0560.

(i)  Is eligible for  a categorically needy (CN) medicaid program.

(j)  Refuses or fails to cooperate with CN medicaid program rules or requirements.

(3)  An individual who resides in a public institution and meets all other requirements may be eligible for MCS depending on the type of institution.  A "public institution" is an institution that is supported by public funds, and a governmental unit either is responsible for it or exercises administrative control over it.

(a)  An individual may be eligible for MCS if the individual is:

(i)  A patient in a public medical institution; or

(ii)  A patient in a public mental institution and is sixty-five years of age or older.

(b)  An individual is not eligible for MCS when the individual is in the custody of or confined in a public institution such as a state penitentiary or county jail, including placement:

(i)  In a work release program; or

(ii)  Outside of the institution including home detention.

4.  If an enrollment cap exists under WAC 182-508-0150, a waiting list of persons may be established.