Medicaid Policy
Medicaid Policy
Previous Policy (404-5 was previously found in 476-1 until November 1, 2021)
A. Financial Responsibility
Refer to the applicable policy in section 404 to determine household size for medically needy coverage.
1. Financial responsibility for medically needy coverage is limited to a spouse for a spouse and parents for their dependent children. Policy prohibits the deeming of a child's income and assets to a parent.
2. Policy prohibits the deeming of a sibling's income and assets to another sibling.
3. Do not count income of an unmarried partner to determine eligibility of a parent, even if they have one or more dependent children in common.
B. Whose Income to Count
Count income as follows for family members who are living together:
1. To determine eligibility for either the parent or the parent's spouse on Family Medically Needy, count income of both the parent and the parent's spouse.
2. To determine eligibility for a child on either Family or Child Medically Needy, count the income of both the child and the child's parents, but not the child's siblings. (See 415-5 for child support payments; 415-1 for unearned income; 419-5 for income that is excluded for a child.)
a. If a child meeting the age criteria is emancipated, continue to count the parents' income.
b. Count income of a child's spouse, if applicable.
c. Do not count income of a non-parent caretaker.
3. A parent, stepparent or adoptive parent who receives SSI cannot be included in the household size and their income and assets will not be counted in determining eligibility for family-related Medicaid.
4. To determine eligibility for a woman on Pregnant Woman Medically Needy, count income of the pregnant woman and her spouse.
a. If a pregnant woman is under age 18 and living with her parents, count her parent's income (405-1).
b. If a pregnant woman is between the age of 18 and 19, living with her parents, does not meet dependent child criteria 402-3, and fails the MAGI-based Pregnant Woman program, count only her income and that of her spouse. 405-3)
5. Count the income of the unmarried father of an unborn child only to determine his eligibility for Family Medically Needy Medicaid.
· If he is under age 18 and living with his parents, or 18 and meets dependent child criteria, count his parents' income, too.
6. Temporary absence or status as an ineligible non-citizen does not change how to count income from that person (401-4, 401-5).