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Effective: May 1, 2007 |
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03.20.20ar2 - MinnesotaCare for Adults With Children (Archive) |
Archived: February 1, 2008 |
People with children under age 21 in the household are considered an adult with children for MinnesotaCare eligibility if they are:
l A parent. Consider stepparents to be parents regardless of whether the biological or adoptive parent lives in the household.
l A relative caretaker , foster parent or legal guardian who applies for MinnesotaCare with the children.
Eligibility factors are listed below with any information that is unique for this group. Links to standard program guidelines are included as well.
Citizenship/Immigration Status.
Insurance and Benefit Recovery.
Relationship to Other Groups/Bases.
Other Groups/Bases to Consider.
Stepparents must always apply with and be counted in the stepchildren's household. However, a legal guardian, foster parent or relative caretaker may apply as a family or may apply separately for the children for whom they are responsible.
l If they apply with the children, include their income along with the child's in the gross household income for determining eligibility and premium amount.
l If they apply for the children separately, count only the children's income to determine the children's eligibility and premium amount.
Note: Applying for the children separately may result in a lower premium for some households. See Household Composition and Premiums for more information.
Follow standard MinnesotaCare guidelines.
Renewals (standard guidelines)
Follow standard MinnesotaCare guidelines.
Follow standard MinnesotaCare guidelines.
Social Security Number (standard guidelines)
Follow standard MinnesotaCare guidelines.
Parents and relative caretakers who are noncitizens:
l May be eligible with Federal Financial Participation (FFP) if they meet the immigration status requirements for federally funded MA. See Funding Health Care for Noncitizens.
l May be eligible for state-funded MinnesotaCare if they do not meet the immigration status requirements for federally funded MA.
Note: Noncitizens with an undocumented or non-immigrant status are not eligible for MinnesotaCare.
Residency (standard guidelines)
Follow standard MinnesotaCare guidelines.
Follow standard MinnesotaCare guidelines.
Household Composition (standard guidelines)
Biological or adoptive parents, and stepparents must always apply with their children and are always considered part of a family household.
l Relative caretakers, legal guardians and foster parents who apply with the children in their care are considered part of a family household.
Note: Legal guardians and foster parents may be eligible for state-funded MinnesotaCare only.
l Adults who care for children under 21 who live with them but who are not the biological or adoptive parent, stepparent, legal guardian, relative caretaker, or foster parent of any of the children are not considered to be a member of a family with children. See MinnesotaCare for Adults Without Children.
Parents and relative caretakers have either Group Two or Group Four status.
l Group Two includes those with incomes at or below 100% FPG or over 200% FPG.
l Group Four includes those with incomes over 100% FPG but no more than 200% FPG who are citizens or have an immigration status that qualifies for FFP.
Note: Legal guardians and foster parents always have Group Two status, regardless of income or citizenship/immigration status.
Asset Guidelines (standard guidelines)
The asset limit for non-pregnant adults is:
l $10,000 for a household of one.
l $20,000 for a household of two or more.
The income limit is 275% FPG, or $50,000 annual gross income, whichever is less.
Note: Some parents and relative caretakers with incomes over 100% FPG but no more than 200% FPG may qualify for enhanced federal funding. See MinnesotaCare Eligibility Groups.
Deductions/Disregards (standard guidelines)
Follow standard MinnesotaCare guidelines.
Follow standard MinnesotaCare guidelines.
Covered Services (standard guidelines)
MinnesotaCare parents, legal guardians, relative caretakers, and foster parents who apply with the children in their care have some benefit limitations, deductibles, and co-payments which vary depending on household income. They may have one of two benefit sets:
l Basic Plus - This includes people whose total household income is over 175% but less than or equal to 275% FPG (or $50,000, whichever is less). This group has a $10,000 annual limit on inpatient hospital benefits (but no inpatient co-payments).
l Basic Plus Two - This includes people whose household income is equal to or less than 175% FPG. This group does not have an annual limit on inpatient hospital benefits (and also has no hospital co-payments).
Parents, legal guardians, and relative caretakers and foster parents who apply with the children in their care have co-payments for some services, including emergency room visits, prescriptions and eyeglasses, regardless of income. See the MHCP Provider Manual for more information.
Follow standard MinnesotaCare guidelines.
Parents, guardians, and relative caretakers must cooperate with medical support requirements as a condition of eligibility.
l Legal guardians and relative caretakers who refuse to cooperate with medical support for wards or relative children for whom they apply may not reapply separately for themselves.
l Children's eligibility is not affected by a parent, guardian, or relative caretaker's failure to cooperate.
Note: Do not require foster parents to cooperate with medical support requirements.
Legal guardians and foster parents may qualify only for state-funded MinnesotaCare. No federal financial participation (FFP) is available for these enrollees, regardless of income level or immigration status.
Note: For a person who is both a parent/relative caretaker and a legal guardian or foster parent, use the federally funded parent or relative caretaker status for MinnesotaCare eligibility.
Example:
Phyllis is her granddaughter Naomi’s legal guardian, and is applying for MinnesotaCare for them as a household.
Action:
Use the relative caretaker status of ”grandparent” when determining Phyllis’ eligibility and funding.
When adults lose parent or caretaker status, give ten-day notice to change eligibility to the appropriate non-parent major program and group status effective the first available month after the change. See Change in MinnesotaCare Eligibility Group.
Not applicable.
Also consider MA for Parents/Caretakers.