Medicaid Policy                                                                 

 

401-4 MAGI Programs - Joint Custody and Temporary Absence

Effective Date: June 1, 2025

Previous Policy 

 

A.   Joint Custody

Physical living arrangements of a child determine in which household a child should be included.  This is true even when a parent claims to have joint custody of the child. Count a child residing in a parent's home more than 50% of the time in that household, despite custody agreements or court orders.

1.    Do not base household composition solely on a court order awarding custody. Consider the actual circumstances of where the child lives on a case-by-case basis.

 

2.    A child’s physical living arrangement is where the child returns to after a temporary absence or visitation to the other parent.

 

3.    When living arrangements show the child is living 50% of the time in each parent’s household, count the child in the household of the parent who applies first and is found eligible.

·       If both parents apply on the same day, they may decide together in which household to count the child. Document their agreement.

·       If parents dispute which household they want the child to be a part of, request an investigation.

 

4.    When both parents claim they have physical custody of the child more than 50% of the time, verify where the child is currently living, and if it is undetermined make an investigation referral. The investigator will make the decision based on the household circumstances.

 

5.    If there is an actual change of residence of a Medicaid recipient (child begins living in the other parent's household more than 50% of the time), remove the child from the open Medicaid case following advance notice (policy 811). If the other parent has an open medical assistance case, refer to 815-4 about adding a new household member to re-determine the child's eligibility.

 

B.   Temporary Absence

 

1. When a child is in Division of Child and Family Services (DCFS) or Juvenile Justice and Youth Services (JJYS) custody, the child is not considered temporarily absent.

 

2.   MAGI-Based and Family Medically Needy programs: An individual is temporarily absent if:

a.       The individual lives away from home because of work, education, medical care, military service, vacation or some other temporary purpose (example: volunteer services for a church or the Peace Corps) and

b.       The individual intends to return to the home when the reason for the absence ends.

 

3.       There is no time limit for a temporary absence as long as the family member intends to return to the home.  

a.       If the absent family member changes their intent so that they do not intend to return, they are no longer temporarily absent. They are no longer a member of the  household at the point that their intent changes or if there are factors conflicting with Utah Residency, see 207-5.

b.       If there are factors conflicting with Utah Residency see 207-1.

c.       If the absent family member is in a medical institution, see 215-4 and 463 to determine that person's eligibility and cost of care.

 

4.       MAGI related programs:      

a.       Tax filer household: A person may be absent from the household and still count as a household member if the tax filer still expects to claim the person as a dependent or a spouse filing jointly on their tax return.

·       See section 401-2 for permanently separated spouses who file a joint return.

b.    Non-filer households: a person would have to live in the household or be temporarily absent to be included in the household size. 

c.    Regardless of tax filing status, when a member is an incarcerated individual of a public institution such as a jail or prison, take the client’s statement that the individual is temporarily absent.