The Alaskans Living Independently (ALI) Medicaid Waiver is intended to assist seniors 65 years of age and older or adults 21 years of age to 64 years of age who are physically disabled, and in need of a Nursing Facility Level of Care (NFLOC). Through this statewide waiver program, services are provided, such as care coordination, adult day care, and respite care, which allow program participants to continue to live at home, while also providing support to their caregivers. Modifications to the home to help promote independence, like wheelchair ramps and widening of the doorways, home delivered meals, and specialized medical equipment, are also covered benefits of this waiver.
It is not a requirement of the program that the participants remain living at home. They can reside in an assisted living community (more formally referred to as “residential supportive living”), but this may limit the range of services for which they are eligible. Program participants cannot reside in a nursing home.
This Medicaid waiver program is administered by the Alaska Department of Health and Social Services’ (DHSS) Division of Senior and Disabilities Services (DSDS). Alaskans Living Independently was created as a replacement for two previous state Medicaid programs: Older Alaskans Program and the Adults with Physical Disabilities Medicaid Waiver. To avoid confusion, it is worth mentioning that Medicaid in the state of Alaska is sometimes referred to as Denali Care.
Medicaid eligibility is complicated and the requirements change based on individual criteria, such as age and marital status. What follows is accurate in 2021 for Alaskan residents who are aged 65 or older and those between 21 and 64 years of age who are physically disabled as designated by Social Security. To be eligible for the Alaskans Living Independently waiver, an individual must meet the following requirements.
1) Care Needs – Require a nursing facility level care of care. In other words, if not for the services provided by this waiver, it would be necessary for the individual to reside in a nursing home.
2a) Assets – If single, an applicant must have countable assets valued at no more than $2,000. This excludes the value of one’s home, provided the applicant resides in the home and his / her equity interest does not exceed $603,000. Other assets that are exempt (non-countable) include a vehicle, personal effects, a burial plot, and household items.
2b) Assets – If married, and the applicant’s spouse is not also seeking Medicaid, the applicant is permitted $2,000 and their spouse is permitted to retain up to $130,380 of their joint assets. This is called the Community Spouse Resource Allowance (CSRA). For married couples, all assets are considered jointly owned.
2c) Assets – If married, and both spouses are seeking Medicaid, the couple is able to retain up to $3,000 in assets.
3a) Income – If single, an applicant must not have monthly income exceeding $2,382. This amount is equivalent to 300% of the SSI Federal Benefit Rate.
3b) Income – If married, the Medicaid applicant is permitted up to $2,382 in monthly income and their non-applicant spouse, often referred to as the community spouse, may be permitted up to $3,259.50 per month transferred from his/her applicant spouse. This is called the Minimum Monthly Maintenance Needs Allowance (MMMNA) and is intended to protect the spouse who is not seeking Medicaid services from becoming impoverished. Unlike with assets, Medicaid does not consider income jointly owned.
3c) Income – If married, and both spouses are applying for services, the couple’s income cannot exceed $4,764. (Each spouse is allowed up to $2,382 / month in income.) Again, this figure is calculated at 300% of the SSI Federal Benefit Rate.
4) Asset Transfers – Individuals cannot have gifted or sold assets under market value in the preceding 60 months for the purpose of lowering their assets to gain Medicaid eligibility. This period of time is referred to as the Medicaid Look-Back Period, and violating this period may result in a period of Medicaid ineligibility.
The Alaskans Living Independently Waiver is not an entitlement program, which means the number of people that can receive services via this waiver is limited. Therefore, there may be a wait list. Individuals on the wait list will be prioritized based on those who are most in need of services.
For more information about this waiver, click here. For additional information or to apply, call the Alaska Department of Health and Social Services Senior and Disability Services. Click here to find the number of your local office.