Medicaid Alternative Care (MAC)
To describe the Medicaid Alternative Care program and the eligibility requirements for a person to become eligible.
WAC 182-513-1600 Medicaid Alternative Care (MAC) - Overview
WAC 182-513-1600 Medicaid Alternative Care (MAC)
Effective July 1, 2017
Medicaid alternative care (MAC) is a Washington apple health benefit authorized under section 1115 of the Social Security Act. It enables the medicaid agency and the agency's designees to deliver an array of person-centered long-term services and supports (LTSS) to unpaid caregivers caring for a medicaid-eligible person who meets nursing facility level of care under WAC 388-106-0355.
- For services included with the MAC benefit package, see WAC 388-106-1900 through 388-106-1990.
- For financial eligibility for MAC services, see WAC 182-513-1605.
WAC 182-513-1605 Medicaid alternative care (MAC) - Eligibility.
WAC 182-513-1605 Medicaid alternative care (MAC) — Eligibility.
Effective July 1, 2017
- The person receiving care must meet the financial eligibility criteria for medicaid alternative care (MAC).
- To be eligible for MAC services, the person receiving care must:
- Be age fifty-five or older;
- 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;
- Meet residency requirements under WAC 182-503-0520;
- Live at home and not in a residential or institutional setting;
- Have an eligible unpaid caregiver under WAC 388-106-1905;
- Meet citizenship and immigration status requirements under WAC 182-503-0535 (2)(a) or (b); and
- Be eligible for either:
- An applicant whose eligibility is limited to one or more of the following programs is not eligible for MAC:
- The medically needy program under WAC 182-519-0100;
- The medicare savings programs under WAC 182-517-0300;
- The family planning program under WAC 182-505-0115;
- The TAKE CHARGE program under WAC 182-532-720;
- The medical care services (MCS) program under WAC 182-508-0005;
- The alien emergency medical (AEM) program under WAC 182-507-0110 through 182-507-0120;
- The state funded long-term care for noncitizens program under WAC 182-507-0125;
- The kidney disease program under chapter 182-540 WAC; or
- The tailored supports for older adults (TSOA) program under WAC 182-513-1610.
- The following rules do not apply to services provided under the MAC benefit:
The AAA worker will notify financial staff using the 14-443 communication form when a client has been approved for MAC services.
Financial staff are responsible for ongoing case maintenance on MAC clients. If the case is managed by the CSO, the HCS financial worker will transfer the case into HCS to case manage and update the case to show the MAC approval and start date. This includes processing food assistance requests if applicable.
Note: HCS staff don’t manage MAGI or Breast and Cervical Cancer cases.