1. (1) The person receiving care must meet the financial eligibility criteria for medicaid alternative care (MAC).

2. (2) To be eligible for MAC services, the person receiving care must:

   1. (a) Be age 55 or older;
   2. (b) Be assessed as meeting nursing facility level of care under WAC 388-106-0355, and choose to receive services under the MAC program instead of other long-term services and supports;
   3. (c) Meet residency requirements under WAC 182-503-0520;
   4. (d) Live at home and not in a residential or institutional setting;
   5. (e) Have an eligible unpaid caregiver under WAC 388-106-1905;
   6. (f) Meet citizenship and immigration status requirements under WAC 182-503-0535 (2)(a) or (b); and

   7. (g) Be eligible for either:

      1. (i) A noninstitutional medicaid program, which provides categorically needy (CN) or alternative benefit plan (ABP) scope of care under WAC 182-501-0060; or
      2. (ii) An SSI-related CN program by using spousal impoverishment protections institutionalized (SIPI) spouse rules under WAC 182-513-1660.

3. (3) An applicant whose eligibility is limited to one or more of the following programs is not eligible for MAC:

   1. (a) The medically needy program under WAC 182-519-0100;
   2. (b) The medicare savings programs under chapter 182-517 WAC;
   3. (c) The Washington apple health pregnancy and after-pregnancy coverage program under WAC 182-505-0115;
   4. (d) The family planning only programs under chapter 182-532 WAC;
   5. (e) The medical care services (MCS) program under WAC 182-508-0005;
   6. (f) The alien emergency medical (AEM) program under WAC 182-507-0110 through 182-507-0120;
   7. (g) The state funded long-term care for noncitizens program under WAC 182-507-0125;
   8. (h) The kidney disease program under chapter 182-540 WAC; or
   9. (i) The tailored supports for older adults (TSOA) program under WAC 182-513-1610.

4. (4) The following rules do not apply to services provided under the MAC benefit:

   1. (a) Transfer of asset penalties under WAC 182-513-1363;
   2. (b) Excess home equity under WAC 182-513-1350; and
   3. (c) Estate recovery under chapter 182-527 WAC.

[Statutory Authority: RCW 41.05.021 and 41.05.160. WSR 25-12-036, s 182-513-1605, filed 5/28/25, effective 6/28/25; WSR 23-11-007, § 182-513-1605, filed 5/4/23, effective 6/4/23. Statutory Authority: RCW 41.05.021, 41.05.160, 2016 1st sp.s. c 36 § 213 (1)(e), section 1115 of the Social Security Act, and 42 C.F.R. §§ 431.400 through 431.428. WSR 17-12-019, § 182-513-1605, filed 5/30/17, effective 7/1/17.]