WAC 182-509-0001 Countable income for Washington apple health programs.

WAC 182-509-0001 Countable income for Washington apple health programs.

Effective December 27, 2024.

1. For purposes of Washington apple health program eligibility, a person's countable income is income which remains when:
   1. The income cannot be specifically excluded; and
   2. All appropriate deductions and disregards allowed by a specific program have been applied.
2. A person's countable income may not exceed the income standard for the specific Washington apple health program, unless the program allows for those limits to be exceeded. Specific program standards are described below:
   1. For modified adjusted gross income (MAGI)-based programs described in WAC 182-503-0510, see WAC 182-505-0100 for the applicable program standard based on a percentage of the federal poverty level (FPL);
   2. For Washington apple health SSI-related CN coverage, see WAC 182-512-0010;
   3. For Washington apple health MN coverage, see WAC 182-519-0050;
   4. For Washington apple health medicare savings programs, see WAC 182-517-0100;
   5. For Washington apple health noninstitutional medical in an alternative living facility, see WAC 182-513-1205; and
   6. For Washington apple health long-term care programs, see WAC 182-513-1315 and 182-513-1395.
3. For the MAGI-based programs listed below, the agency or its designee determines eligibility based on the countable MAGI income of the members of the person's medical assistance unit as determined per WAC 182-506-0010:
   1. Washington apple health for parents and caretaker relatives program as described in WAC 182-505-0240;
   2. Washington apple health pregnancy program as described in WAC 182-505-0115;
   3. Washington apple health for kids programs as described in WAC 182-505-0210 with the following exceptions:
      1. Newborn children born to a person who is eligible for WAH on the date of the newborn's birth, including a retroactive eligibility determination;
      2. Children who are receiving SSI;
      3. Children who are in foster care or receiving subsidized adoption services.
   4. Washington apple health MAGI-based adult medical as described in WAC 182-505-0250; and
   5. Washington apple health MAGI-based alien emergency medical as described in WAC 182-507-0110.
4. For the following SSI-related Washington apple health programs, unless the state has adopted more liberal rules, income rules for the SSI program are used to determine a person's countable income:
   1. Washington apple health noninstitutional SSI-related CN or medically needy (MN) coverage described in chapters 182-511 and 182-512 WAC;
   2. Washington apple health institutional SSI-related CN or MN long-term care or hospice coverage described in chapters 182-513 and 182-515 WAC;
   3. Washington apple health alien emergency medical programs based on age 65 or older or disability described in chapter 182-507 WAC; and
   4. Washington apple health medicare savings programs described in chapter 182-517 WAC.
5. Anticipated nonrecurring lump sum payments received by an applicant or recipient of a Washington apple health SSI-related medical program are counted as income in the month of receipt, subject to reporting requirements, with the exception of retroactive supplemental security income (SSI)/Social Security disability lump sum payments. See WAC 182-512-0300(4) and 182-512-0700 for more information.
6. Countable income for the Washington apple health refugee medical (RMA) program and Washington apple health MN program for pregnant people and children is determined as follows:
   1. The agency or its designee allows the following deductions from a household's gross earnings:
      1. The first $500 of earnings and 50 percent of the remaining earnings;
      2. Actual work-related child and dependent care expenses, which are the person's responsibility; and
      3. Court or administratively ordered current or back support paid to meet the needs of legal dependents.
   2. Only income actually contributed to a person from the person's sponsor is countable unless the sponsor signs the affidavit of support I-864 or I-864A.
   3. Nonrecurring lump sum payments are counted as income in the month of receipt and as a resource if the person retains the payment after the month of receipt (resource limits do not apply to MN coverage for pregnant people and children). For RMA, nonrecurring lump sum payments are counted as income if received in the month of application and not considered if received thereafter per WAC 182-507-0130.
7. Countable income rules for other Washington apple health programs that are not MAGI-based or SSI-related are described in the specific program rules listed in WAC 182-503-0510 (3)(c).
8. Some Washington apple health programs are not based on a person's or household's countable income but are based on a specific status or entitlement in federal rule. The rules for these deemed eligible Washington apple health programs are described in WAC 182-503-0510(4).