WAC 182-513-1316. General eligibility requirements for long-term care (LTC) programs

(1) To be eligible for long-term care (LTC) services, a person must: (a) Meet the general eligibility requirements for medical programs under WAC 182-503-0505 , except: (i) An adult age 19 or older must meet citizenship and immigration status requirements under WAC 182-503-0535 (2)(a) or (b); (ii) A person under age 19 must meet citizenship and immigration status requirements under WAC 182-503-0535 (2)(a), (b), (c), or (d); and (iii) If a person does not meet the requirements in (a)(i) or (ii) of this subsection, the person is not eligible for medicaid and must have eligibility determined under WAC 182-513-1319 . (b) Attain institutional status under WAC 182-513-1320 ; (c) Meet the functional eligibility under: (i) Chapter 388-106 WAC for a home and community services (HCS) home and community based (HCB) waiver or nursing facility coverage; or (ii) Chapter 388-828 WAC for developmental disabilities community services (DDCS) HCB waiver or institutional services; and (d) Meet either: (i) SSI-related criteria under WAC 182-512-0050 ; or (ii) MAGI-based criteria under WAC 182-503-0510 (2), if residing in a medical institution. A person who is eligible for MAGI-based coverage is not subject to the provisions under subsection (2) of this section. (2) A supplemental security income (SSI) recipient or a person meeting SSI-related criteria who needs LTC services must also: (a) Not have a penalty period of ineligibility due to the transfer of assets under WAC 182-513-1363 ; (b) Not have equity interest in a primary residence greater than the home equity standard under WAC 182-513-1350 ; and (c) Disclose to the agency or its designee any interest the applicant or spouse has in an annuity, which must meet annuity requirements under chapter 182-516 WAC. (3) A person who receives SSI must submit a signed health care coverage application form attesting to the provisions under subsection (2) of this section. A signed and completed eligibility review for LTC benefits can be accepted for people receiving SSI who are applying for long-term care services. (4) To be eligible for HCB waiver services, a person must also meet the program requirements under: (a) WAC 182-515-1505 through 182-515-1509 for HCS HCB waivers; or (b) WAC 182-515-1510 through 182-515-1514 for DDCS HCB waivers.