Obsolete 0125 343-5 Changes during the 12-Month Transitional Period

Effective Date: November 1, 2016 - December 31, 2024

 

Previous Policy

 

Change in Household Members

Add a person to the 12 Month Transitional Medicaid when:

That person is the spouse of the parent or caretaker relative, or the dependent child of the parent, AND

The person meets Medicaid eligibility requirements such as citizenship and social security number.

 

Example: You must add to the coverage children who are born or adopted into the household, the new spouse of a parent upon getting married, or family members who were absent from the household when MAGI-based Parent/Caretaker Medicaid (PCR) closed, but returned during the 12 month period.

 The household must report the earned income for the new person at the next quarterly income report. (Do not count the new household member’s income until you get that report.)

 Deprivation of support is not a factor when adding a new person to the household.

Remove a person from the 12 Month Transitional Medicaid when:

The person leaves the household and the absence is not temporary.

A child no longer meets the age requirement to qualify a parent or caretaker relative for PCR Medicaid.  

 

When to Close 12 Month Transitional

Close the 12 Month Transitional with proper notice in the following situations:

The person who leaves is the only age eligible dependent child.

The only child no longer meets the age requirement to qualify a parent or caretaker relative for the PCR Medicaid.

The household moves out of state.

The parent or caretaker relative has received the initial 6 months of the 12 Month Transitional, is completing the second or third quarterly report, and

 The person is eligible for PCR Medicaid again due to a decrease in income or an increase in household size, and

  reports that the change will be ongoing.  

Close 12 Month Transitional if the member fails to report properly (See 343-2).

Close 12 Month Transitional at the end of the 12th month.

Before closing the 12 Month Transitional, for whatever reason, re-determine eligibility for any other Medicaid programs for each household member. Move the household members to the appropriate Medicaid program before closing the 12 Month Transitional.