WAC 182-512-0700 SSI related medical -- Income eligibility.

1. In order to be eligible, an individual is required do everything necessary to obtain any income to which he or she is entitled including (but not limited to): 

a.  Annuities,

b.  Pensions,

c.  Unemployment compensation,

d.  Retirement, and

e.  Disability benefits; even if their receipt makes the individual ineligible for agency services, unless the individual can provide evidence showing good reason for not obtaining the benefits.

2.  The agency or its authorized representative does not count this income until the individual begins to receive it.  Income is budgeted prospectively for all medical programs.

3.  Anticipated nonrecurring lump sum payments other than retroactive SSI/SSDI payments are considered income in the month received, subject to reporting requirements in WAC 388-418-0007(4). Any unspent portion is considered a resource the first of the following month.

4.  The agency or its authorized representative follows income and resource methodologies of the Supplemental Security Income (SSI) program defined in federal law when determining eligibility for SSI related medical or Medicare Savings programs unless the agency adopts rules that are less restrictive than those of the SSI program.

5.  Exceptions to the income methodology:

a.  Lump sum payments from a retroactive SSDI benefit, when reduced by the amount of SSI received during the period covered by the payment, are not counted as income;

b.  Unspent retroactive lump sum money from SSI or SSDI is excluded as a resource for nine months following receipt of the lump sum; and

c.  Both the principal and interest portions of payments from a sales contract, that meet the definition in WAC 182-512-0350 (10), are unearned income.

6.  To be eligible for categorically needy (CN) SSI related medical coverage, an individual's countable income cannot exceed the CN program standard described in:

a. WAC 182-512-0010 for noninstitutional medical unless living in an alternate living facility; or

b. WAC 388-513-1305(2) for noninstitutional CN benefits while living in an alternate living facility; or

c. WAC 388-513-1315 for institutional and waiver services medical benefits.

7.  To be eligible for SSI related medical coverage provided under the medically needy (MN) program, an individual must:

a.  Have countable income at or below the effective MN program standard as described in WAC 182-519-0050; or

b.  Satisfy spenddown requirements described in WAC 182-519-0110;

c.  Meet the requirements for non-institutional MN benefits while living in an alternate living facility (ALF). See WAC 388-513-1305(3); or

d.  Meet eligibility for institutional MN benefits described in WAC 388-513-1315.