*** The Health Care Programs Manual (HCPM) has been replaced by the Minnesota Health Care Programs Eligibility Policy Manual (EPM) as of June 1, 2016. Please refer to the EPM for current health care program policy information. ***
Effective: July 1, 2012 |
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17.05 - Determining Household Size for MA |
Archived: June 1, 2016 (Previous Versions) |
The MA household size is determined separately for each person.
This section contains the general rules to determine the MA household size for an individual. Please see Exceptions to MA Household Size for rules that apply in specific circumstances.
MA General Household Size Policy.
MA General Household Size Policy
Family members must be in the household for one full calendar month or more to be included in the household size, unless the person has a temporary absence.
Note: A person who moves in on the first of the month increases the household size for the month following the month of entry.
Example:
Antonio (age 18) moves back in with his parents, who are on MA, on April 1.
Action:
Antonio will increase his parents' household size in May.
Count people who are under house arrest as household members and include them in the household size following standard household size policy.
Include the following people living with the adult client in that adult's household size:
l The client.
l Spouse.
l Biological or adoptive children under age 21 of the client.
n A child who is temporarily absent from the parent’s home is included in the parent’s household size, such as a student away at school for the school year.
n If a child alternates living with separated or divorced parents:
m Consider the child to be in the household in which he or she spends the most time.
m If the time is equally divided and both parents apply for MA and list the same child as a household member, consider the child to be in the household of the parent who applied first. If the child is not counted in that parent's household, he or she can be counted in the other parent's household. Do not consider a child to be a member of more than one MA household in the same month.
Note: A child can be included in both an MA household and MinnesotaCare household in the same month.
m Base the determination of a child’s household on current circumstances. Use the custody information from a court order only in contested cases.
Example:
Emma alternates living with her divorced parents each week. Custody is equal, with each parent having Emma 50% of the time. Emma and her mother are enrolled in MA on Emma's mother's case. Emma’s dad applies for MA for himself.
Action:
Do not count Emma in her dad’s household size. Emma’s dad does not have a parent basis of eligibility if he does not have any other dependent children counted in his MA household size.
Example:
Joey alternates living with his divorced parents each week. Custody is equal, with each parent having Joey 50% of the time. Joey is enrolled in MinnesotaCare as a member of his father's household. Joey’s mother applies for MA for herself.
Action:
Count Joey in his mother's household size since neither Joey nor Joey's father is enrolled in MA.
Example:
Sophia alternates living with her separated parents each week. Custody is equal, with each parent having Sophia 50% of the time. Sophia's mother applies for MA on June 1 for her nephew Justin, who lives in her home. She does not request MA for herself or Sophia. MA is approved for Justin. His MA household size in one. Sophia and her mother are not counted as part of Justin's MA household.
Sophia's father applies for MA for himself only on July 1. He lists Sophia as a member of his household.
Action:
Count Sophia in her father’s household size since she is not enrolled in MA and is not counted in the household size of any person enrolled in MA.
l Biological or adoptive children under age 21 of the client's spouse.
n The spouse must also be living with the client, or be considered temporarily absent to count these children in the client’s household size.
n If children alternate living with separated or divorced parents:
m Consider them to be in the household in which they spend the most time.
m If the time is equally divided and both parents apply for MA for the same child, consider the child to be in the household of the parent who applies first. If the child is not counted in that parent's household, he or she can be counted in the other parent's household. Do not consider children to be members of more than one MA household in the same month.
m Base determination of a child’s home on current circumstances. Use the custody information from a court order only in contested cases.
Example:
Roger lives with his mom and step-dad. Roger stays with his dad during summer vacation. Roger’s step-dad applies for MA.
Action:
Count Roger in his step-dad’s household size because he spends the majority of his time in that household. However, do not deem the step-dad’s income to Roger. See Deeming Income and Assets for more information on whose income to deem.
l Unborn child or children of the client or client’s spouse.
n To include more than one unborn child, the multiple pregnancy must be verified.
n The spouse must be living with the client, or be considered temporarily absent, to have the spouse’s unborn child counted in the client’s household size.
The following people are not included in an adult’s household size:
n Emancipated minors who are the children of the client or stepchildren of the client’s spouse.
n Children under age 21 who are not the children of the client or the client’s spouse.
n Children age 21 and over of the client or the client’s spouse.
n The other parent of a child in the household if the parents are not married to each other.
n Other children such as grandchildren, nieces, or nephews.
n A spouse residing in the same long-term care facility (LTCF), even if they are in the same room, is not counted in the client’s household size. See Exceptions to MA Household Size for more LTC information.
Example:
Kelly, age 30, lives with her husband, Jason, her daughter from a previous marriage, and Jason's son from a previous marriage. Kelly is pregnant and expecting a medically verified single birth.
Action:
Kelly and Jason each have a household size of five. Kelly’s household size includes herself, Jason, her child, her stepchild and her unborn child. Jason’s household includes the same people.
Example:
Henrietta and Augustus are married, and have been for over 40 years. Their 35-year-old son, Barney, lives with them. They are all applying for health care.
Action:
Henrietta and Augustus each have a household size of two: count each of them in the other’s household size and themselves. Do not count Barney in their household size because he is over age 21. Barney has a household size of one. He is an adult who does not have a spouse or child in the home.
Example:
Tina and her 16-year-old daughter live with Tina’s friend Jeff, and Jeff’s 10-year-old son.
Action:
Tina and her daughter are each a household size of two, counting each other. Jeff and his son would also have a household size of two. There is no marital relationship to put Tina and Jeff into a household together.
Include the following people living with the child, or who are temporarily absent, in that child's household size:
l The child.
l The child's biological or adoptive parents.
Note: Follow MA Adult's Household Size provisions for children who alternate living equally with separated or divorced parents.
l A stepparent, if a biological or adoptive parent also lives in the home.
l Other children (full or half-siblings) who have a mutual parent living in the home, or who is temporarily absent.
l Children under age 21 of a stepparent (step-siblings) who lives in the home or is temporarily absent, and the biological or adoptive parent also lives in the home.
l An unborn sibling or half-sibling with whom the child shares a legally established common parent if that biological or adoptive parent also lives in the home.
Note: Count multiple unborn siblings if a multiple pregnancy is verified.
l The child's spouse.
l The child's minor children.
l The child’s unborn children if the child is pregnant or married to the pregnant spouse.
The following people are not included in a child’s household size:
n Adults who live with the child, unless the adult is a parent or stepparent and the biological or adoptive parent also lives in the home.
n Siblings under 21 if the mutual parent is not living in the home.
n Emancipated siblings or step-siblings.
n Siblings or step-siblings age 21 and over.
If a child is emancipated, do not include the following, even if they live with the child:
n The child’s parents.
n The child’s stepparent.
n Siblings.
n Step-siblings.
Example:
Allie, age 10, lives with her mother, Kelly, and her stepfather, Jason. Allie is applying for health care.
Action:
Allie has a household size of three, which includes herself, her mother and her stepfather, because her mother lives in the home.
Jason’s son, Garrett, age five, moves into the home. They now apply for health care for Garrett.
Action:
Allie’s household size changes to four, which includes herself, her mother, her stepfather and Garrett, her stepbrother. Garrett’s household size is also four, which includes himself, his father, his stepmother and Allie, his stepsister.
Jason and Kelly divorce. Garrett continues to live with Kelly and Allie.
Action:
Allie’s household size changes to two, which includes herself and her mother. Garrett can no longer be included in her household size because his father no longer lives in the household. Garrett’s household size changes to one. We can no longer count Allie or Kelly in his household size because his father no longer lives in the home.
Example:
Megan, age 18, lives with her parents, her sister, and Megan's two-year-old son.
Action:
Megan has a household size of five which includes herself, her parents, her sister, and her son.
Megan's parents each have a household size of four which includes themselves, their spouse, and their two children.
Megan's sister has a household size of four which includes herself, Megan, and their parents.
Megan's son has a household size of two, which includes himself and Megan.
Megan marries her son’s father and he moves into the family household.
Action:
Megan’s household size, along with her son’s, changes to three to include Megan, the son and Megan’s husband (the son’s father). Megan’s parent’s household size, and her sister’s, changes to three. Megan is now emancipated and removed from their household.
Example:
Betsy and Sarah are minor siblings who live with their aunt. The aunt applies only for the girls.
Action:
Betsy and Sarah each have a household size of one. Because they do not have their biological or adoptive parent in the home we cannot count them in one another’s household size.
Example:
Alicia and Jay live together but are not married. They have a mutual daughter, London, age two, and Alicia is pregnant with one child. They all apply for health care.
Action:
Alicia has a household size of three, which includes herself, her daughter, and her unborn child. Because Alicia and Jay are not married they cannot be counted in each other’s household size.
Jay has a household size of two which includes himself and his daughter.
London has a household size of four which includes herself, her mother, her father, and her unborn sibling. See MA Child’s Household Size.
Example:
Robin and Mark live with their two-year-old son. They are not married. Paternity has been legally established.
Action:
Robin has a household size of two, which includes herself and her son. Mark is not included in Robin’s household size because they are not married.
Mark has a household size of two, which includes himself and his son. Robin is not included in Mark’s household size because they are not married.
The son has a household size of three, which includes himself, his mother and his father.
Example:
Jeanne lives with her 17-year-old daughter, Hannah, and Hannah’s infant son, Josh.
Action:
Jeanne has a household size of two, counting herself and her daughter. Josh cannot be counted in Jeanne’s household.
Hannah has a household size of three. Count her mother and her son in her household.
Josh has a household size of two. Count his mother in his household.