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Eligible

In Alaska, there are several ways to pay for services that can be provided in your home. The services vary in each community dependent on your needs and the availability of providers in your specific location.

Medicaid

Medicaid is provided through the State of Alaska Department of Public Assistance (DPA) with money that comes from the Federal Government.  The Medicaid program is one of many entitlement programs that are based on your income, assets, demographics, and level of need. Medicaid is a health insurance program to assist with medical expenses.

Medicaid Quick Check

Medicaid application process

Be sure to prepare before applying:

  • Bank statements for all accounts for the last 6 months, DPA can ask up to last five years. ​
  • Income verification letters/paystubs from all sources of unearned and earned Income​
  • ID Card, Birth Certificate, passport​
  • Immigration or naturalization documents​
  • Medicare Card, medical bills​
  • Bills for childcare, shut-off notices, child support obligations​
Do you have your documents ready?
  1. Apply
    Application for Medicaid using form GEN50C Application for Services , Elders and applicants with disabilities are encouraged to use the paper application. Medicaid can be applied for online through www.heathcare.gov, through www.my.alaska.gov through the ARIES Self-Portal under individual services, or by phone eligibility at 1-800-478-7778. The application process requires the completion of a phone interview with the staff at the Division of Public Assistance. ​
  2. Prepare for your phone interview

Tips when Applying:​

  1. Complete as much information as possible in the application.​
  2. Submit, if possible, back up documentation outlined on page two of the application, ID card, banking statements, income verification letters etc. If not submit what you can with the application and gather records prior to your interview.​
  3. Watch for the interview letter in the mail. Make sure to keep the appointment via the phone number listed in the letter or call to make changes prior to the appointment. Missing the interview is a direct denial of services. ​
  4. Keep a watch on the mail for letters. If the letter is confusing seek support via the ADRC, Case managers, social workers, navigators etc. in your community. ​
  5. Follow up to send any additional information in a timely manor. Often, DPA will request additional bank statements or ask to clarify a large purchase with receipts/explanation. ​
  6. If denied, you can Appeal. You must follow the instructions on your denial letter. Alaska Legal Services and/or Disability Law Center can assist with appeals and the creation of Miller Trust documents, if needed.
Be sure to prepare before applying:

  • Bank statements for all accounts for the last 6 months, DPA can ask up to last five years. ​
  • Income verification letters/paystubs from all sources of unearned and earned Income​
  • ID Card, Birth Certificate, passport​
  • Immigration or naturalization documents​
  • Medicare Card, medical bills​
  • Bills for childcare, shut-off notices, child support obligations​

The Medicaid Program is made of several smaller programs based on your specific needs.

Note: Click here for Medicaid Waiver programs

Medicaid Waiver

Medicaid Wavier is a program that extends the medical support and rehabilitative services of Medicaid to an individual based on specific assessed and diagnosed conditions.  The program offers payment for Home and Community Based services or institutional care in a facility, such as an Assisted Living Home or Group Home.

Quick Check

These waiver programs offer a choice of services for people who meet a nursing facility level of care (NFLOC). ​
To access one of these waiver programs, a person must meet:

  1. Medicaid eligibility requirements for income and resource limits, as found the application process with the Division of Public Assistance (DPA), and  ​
  2. Level of care requirements, is assessed and determined by the State of Alaska Division of Senior and Disabilities Services Assessment Unit. The assessor conducts a functional assessment via in person interviews or by using videoconferencing technology. ​

As with any government process there are several steps to take to apply for the services.

Medicaid Waiver Process Outline

Steps to obtain a Medicaid Waiver​

1. Application for Medicaid using form GEN50C Application for Services

(http://dpaweb.hss.state.ak.us/e-forms/pdf/GEN-50C.pdf),  Elders and applicants with disabilities are encouraged to use the paper application. The application process requires the completion of a phone interview with the staff at the Division of Public Assistance.  At the time of the interview, the applicant can tell the interviewer that they are seeking the Medicaid Wavier services.  If the applicant is income eligible for Medicaid, the interviewer can adjust the program type to the Medicaid Waiver.  The applicant will be determined if they are eligible for both medical care services and higher level of services under the Medicaid Waiver.
1a) Application for Medicaid using form MED-4, (http://dpaweb.hss.state.ak.us/e-forms/pdf/MED-04.pdf) Medicaid Application for Adults and Children with Long Term Care Needs is a paper application.  The income eligibility for only the Medicaid Waiver is higher than Medicaid thus an applicant could obtain a Medicaid Waiver but not have Medicaid covering all medical care services. ​

2. Contact the local Aging and Disability Resource Center (ADRC)

In SE Alaska this is Southeast Alaska Independent Living (SAIL).  They can be reach at 1-800-478-7245 or on the web at https://www.sailinc.org/.  Ask them for an appointment for a Person-Centered Intake (PCI).  The PCI is an assessment that SAIL staff will conduct with the applicant.  There is no cost related to the assessment.  The assessment process takes about an hour and will offer the applicant with information about their potential eligibility for Medicaid Home and Community Based Services (HCBS), Community First Choice (CFC), and  Personal Care Services (PCS).  SAIL staff will counsel the applicant about their options for services.  ​

    1. When potential eligibility for HCBS occurs, the SAIL staff will provide a referral to a Care Coordinator who can assist with the finalizing of an application for the Medicaid Waiver Services and the development of a Plan of Care.​
      • The Care Coordinator will assist the applicant in establishing a Nursing Facility Level of Care (NFLOC)Assessment through the Division of Senior and Disabilities Services.   From the date that the Care Coordinator submits a completed application the State of Alaska has 30 days to schedule the NFLOC assessment with the applicant.   This assessment is conducted in-person or by video-conferencing to determine the functional eligibility for the Medicaid Waiver.  The assessment determine the level of care that the applicant’s medical condition meets.  To be eligible for Medicaid Waiver the applicant must meet nursing home level of care. To meet NFLOC, the participant must meet the criteria by needing 1) substantial amounts of medical care or 2) extensive hands-on assistance with three or more activities of daily living (ADL) (however needing assistance with bathing and dressing is not counted). Individuals can also meet NFLOC though different combinations of medical care, ADLs, behavior and/or cognition issues.
    2. When potential eligibility for PCS occurs, the SAIL staff will provide the applicant with information regarding local agencies that provide PCS services.
      The applicant then contacts the agency of their choice directly to establish services. ​
3. Picking a PCS agency

Many communities in Se Alaska have limited agencies to choose from for services. See community specific for choices​

The Medicaid Wavier Program offers several options:​