182-514-0250  <<  182-514-0260 >>   182-514-0263

WAC 182-514-0260

Institutional program for children under age nineteen.

(1) To qualify for the modified adjusted gross income (MAGI)-based long-term care (LTC) program under this section, you (a child under age nineteen) must meet:
(a) The general eligibility requirements in WAC 182-514-0240; and
(b) Program requirements under WAC 182-505-0210 or 182-505-0117.
(2) If you are eligible for the premium-based children's program under WAC 182-505-0215, we redetermine your eligibility under this section so that your family is not required to pay the premium.
(3) The categorically needy (CN) income level for LTC coverage under this section is two hundred ten percent of the federal poverty level after the standard five percentage point income disregard.
(4) To determine countable income for CN coverage under this section, we apply the MAGI methodology under chapter 182-509 WAC.
(5) We approve CN coverage under this section for twelve calendar months (certification period). If you are discharged from the facility before the end of the certification period, you remain continuously eligible for CN coverage through the certification period, unless you age out of the program, move out-of-state, or die.
(6) If you are not eligible for CN coverage under this section, we determine your eligibility for coverage under the institutional medically needy program described in WAC 182-514-0263.
(7) The institution where you reside may submit an application on your behalf and may act as your authorized representative if you are:
(a) In a court-ordered, out-of-home placement under chapter 13.34 RCW; or
(b) Involuntarily committed to an inpatient treatment program by a court order under chapter 71.34 RCW.
[Statutory Authority: RCW 41.05.021 and 41.05.160. WSR 17-12-017, § 182-514-0260, filed 5/30/17, effective 6/30/17; WSR 16-04-087, § 182-514-0260, filed 1/29/16, effective 2/29/16. Statutory Authority: RCW 41.05.021 and Patient Protection and Affordable Care Act (P.L. 111-148), 42 C.F.R. §§ 431, 435, and 457, and 45 C.F.R. § 155. WSR 14-06-068, § 182-514-0260, filed 2/28/14, effective 3/31/14. WSR 12-02-034, recodified as § 182-514-0260, filed 12/29/11, effective 1/1/12. Statutory Authority: RCW 74.04.055, 74.04.057, 74.08.090, 74.09.530, and 42 C.F.R. 441.151. WSR 09-06-029, § 388-505-0260, filed 2/24/09, effective 3/27/09.]
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