WAC 182-514-0250 Eligibility for family institutional medical for individuals twenty-one years of age or older.

1.  Individuals twenty-one years of age or older must meet the requirements in WAC 388-505-0240  to qualify for family institutional medical coverage.

2.  Individuals, twenty-one through sixty-four years of age who are admitted to an institution for mental diseases (IMD) are not eligible for coverage under this section. Individuals who are voluntarily admitted to a psychiatric hospital may be eligible for coverage under the psychiatric indigent inpatient program described in WAC 388-865-0217. 

3.  Rules governing resources are described in WAC 388-505-0245.  However, if an applicant has countable resources over the standard described in WAC 388-505-0245, he or she may spend down any excess amount towards his or her cost of care as described in WAC 388-505-0265 (6).

4.  The categorically needy income level (CNIL) for individuals who qualify for family institutional medical coverage under this section is the temporary assistance for needy families (TANF) one person payment standard based on the requirement to pay shelter costs described in WAC 388-478-0020.  An individual's countable income must be at or below this amount to be eligible. 

5.  If the individual's income exceeds the standards to be eligible under a categorically needy (CN) medicaid family program, he or she is not eligible for coverage under the medically needy (MN) medicaid program.

6.  Individuals eligible under the provisions of this section may be required to contribute a portion of their income towards the cost of care as described in WAC 388-505-0265.