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388-106-1900  <<  388-106-1905 >>   388-106-1910

PDFWAC 388-106-1905

Am I eligible for MAC services?

(1) You are eligible to receive MAC services if you, as a care receiver, meet the following criteria:
(a) Are age 55 or older;
(b) Meet nursing facility level of care as defined in WAC 388-106-0355;
(c) Meet medicaid financial eligibility requirements as defined in WAC 182-513-1605;
(d) Have an unpaid caregiver who:
(i) Is age 18 or older;
(ii) Has participated in the following:
(A) Care plan for step one services;
(B) TCARE screening and care plan for step two services; or
(C) TCARE assessment and care plan for step three services;
(e) Live in a private residence (such as your own home or a family member's home) and choose to receive community based services; and
(f) Do not receive any other medicaid funded long-term services and supports (LTSS) while receiving MAC services.
(2) The department may use preliminary information you provide through a presumptive eligibility screening to determine if you, as the care receiver, meet the eligibility criteria in subsection (1) of this section in order to receive services while the formal eligibility determination is being completed. This is called presumptive eligibility.
(a) Your presumptive eligibility period ends with the earlier date of:
(i) The date you were confirmed not to meet full functional eligibility criteria; or
(ii) The last day of the month following the month when your MAC services were first authorized.
(b) In the event the department implements a waitlist under WAC 388-106-1970 for MAC services, your presumptive eligibility ends.
(c) You may only receive services under presumptive eligibility once within a 24 month period.
(d) Under presumptive eligibility you may receive services as described in WAC 388-106-1915.
[Statutory Authority: RCW 74.08.090 and 74.39A.030. WSR 22-18-004, § 388-106-1905, filed 8/25/22, effective 9/25/22. Statutory Authority: RCW 74.08.090. WSR 18-08-033, § 388-106-1905, filed 3/27/18, effective 4/27/18.]
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