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Effective: December 1, 2006 |
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17.10.05ar1 - Three-Generation Households (Archive) |
Archived: October 1, 2009 |
Standard MinnesotaCare (MCRE) household composition policy indicates all people with a parental or marital relationship are considered to be in the same household. A three-generation household may be an exception to normal household composition rules for MCRE when the total household income exceeds the income limit, creating ineligibility for all.
This policy is a means of creating eligibility for the youngest generation of a three-generation household. The three-generation household policy allows the youngest generation to have their eligibility determined, in certain situations, based on only their immediate parental relationships and not include the grandparent in the MCRE household.
What is a Three-Generation Household?
Three-Generation Household Determination Steps.
What Is a Three-Generation Household?
A three-generation household consists of:
l Parent of a child under 21 years old who has a child.
l Child under age 21 who is the parent of a minor child. This person is also referred to as the minor parent.
l Child of the minor child.
Example:
Glory, age 17, lives with her parents, Rudolpho and Leann. Glory has a one-year old, Ernie, who lives with her. Ernie’s father, Randy, also lives in the household, however, he and Glory are not married.
Action:
According to standard household composition rules, Glory, her parents, Ernie, and Randy are a MCRE household because the parental and marital relationships tie them all together. They are a three-generation household.
Three-Generation Household Determination Steps
Follow these steps to determine when the three-generation household may use the MCRE household size exception:
1. Determine if the minor parent’s children have current health care coverage and if that coverage is considered underinsured. See underinsured for policy requirements.
2. Determine eligibility for the entire household based on standard household composition rules.
3. If the minor parent’s child is ineligible for any of the following reasons, continue on to Step 4.
n The household income is over 275% of the FPG.
n The minor parent’s child is underinsured and the household income is over 150% FPG.
n The grandparents refuse to cooperate in providing information needed to determine eligibility for the minor parent’s child.
n If none of these conditions are met and the household is:
m Eligible: no exception to household composition rules is needed.
m Not eligible: deny eligibility. No exception to household composition rules is needed.
4. Determine eligibility for the minor parent’s child and the parent of that child who is only included in the first household because of the parental relationship to the child on a separate case.
n Use a household composition that includes only the minor parent and the minor parent's child.
n Do not include the grandparents or other children of the grandparents.
n The minor parent’s eligibility is determined on the first case, which includes the minor parent’s parent. Deny eligibility for the minor parent on the second case.
Example:
Anne lives with her unmarried 16-year-old daughter, Sara, and Sara's one-year-old son, Jacob. Anne is working and is earning $500 a month. Sara does not work. No one in the house has insurance or access to insurance.
Action:
1. Jacob does not have current insurance.
2. The household consists of Anne, Sara and Jacob, because Sara has a parental relationship with both Jacob and Anne (she is Anne's daughter and Jacob's mother). The household income is less than 275% FPG.
3. Everyone in the household is determined to be eligible. No exception to household composition policy is needed.
Example:
Bob and Grace live with their 19-year-old daughter, Linda, her one-year-old daughter, Rachel, and Rachel's father, Justin, who is 22 years old.
l Bob and Grace have income greater than 275% FPG.
l Bob has full health insurance benefits through his employer for himself, Grace, and Linda. Justin earns less than 150% FPG.
l Justin and Rachel have current health insurance coverage through Justin’s employer. The insurance is underinsured.
l Linda applies for herself, Justin and Rachel.
Action:
Linda is ineligible for MinnesotaCare because she is over income. Justin is ineligible for MinnesotaCare because he has current health insurance. Rachel is eligible for MinnesotaCare, because their income is less than 150% FPG and their current health insurance coverage is underinsured. The following steps were used to determine eligibility:
1. Rachel’s insurance is underinsured.
2. Everyone is included in the household size of five. Bob and Grace have a marital relationship. They have a parental relationship to Linda, who in turn has a parental relationship to Rachel. Justin also has a parental relationship to Rachel.
3. Household income is over 275% FPG, based on Bob and Grace’s income and Justin’s income. They are not eligible as one household because they are over income.
4. Redetermine eligibility for Rachel and Justin on a separate case.
l The household size is three because Linda must be included due to her parental relationship to Rachel.
l The household income is less than 150% FPG using only Justin’s income, because Linda is not employed.
l Justin is ineligible due to his current health insurance coverage.
l Rachel is eligible because her household income is less than 150% FPG and she is underinsured.
l Linda’s eligibility must be denied on this case because it must be determined on her parents' case to include their income, as they have a parental relationship to her.