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Effective: December 1, 2006 |
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16ar1 - Medical Support (Archive) |
Archived: September 1, 2009 |
One requirement for Minnesota Health Care Program coverage is for biological and adoptive parents to help provide health care for their children. When both parents live with the child, this requirement is generally met by deeming the parents' income to the child (for Medical Assistance) or by considering the household income for parents and their children together (for MinnesotaCare).
However, if one or both parents do not live with the child, or parental income is not deemed because of other policy provisions (such as waiver program eligibility), a referral for medical support or the determination of a parental fee may be required.
Medical support may include, as noted in the glossary definition: "Cash payments or health insurance coverage that a non-custodial parent provides or is court-ordered to provide to meet the medical needs of the non-custodial parent's children."
As part of the medical support process, some people may need to establish the identity of a child's legal father, also known as establishing paternity. Paternity must be established before a medical support order can be established or enforced.
There are a number of terms we commonly use to discuss medical support. See the glossary for additional information for some of the following terms.
A voluntary or court-ordered payment by non-custodial parents for the financial support of their children.
A parent who has physical custody of his or her minor child.
The circumstances beyond a person's control which keep the person from following program requirements or specific eligibility conditions, such as cooperation with medical support.
A state, county, or private agency that is responsible for establishing paternity and collecting child support and medical support according to Title IV-D of the Social Security Act.
For purposes of medical support referrals, a minor caretaker is a person under the age of 18 years who has never been married or otherwise legally emancipated who is a birth parent of a minor child.
A child under age 18.
A parent who does not have physical custody of his or her child.
An amount assessed to the parents of a minor child as reimbursement for the cost of care of a child under 18 who receives MA without consideration of parental income.
Legal fatherhood, either adjudicated or acknowledged by the father.
Recognition of Parentage (ROP) .
A form (DHS-3159) printed by the Minnesota Department of Human Services (DHS) that serves as legal acknowledgement of paternity.
The part of the Social Security Act that authorizes establishing paternity and collecting child and medical support by the IV-D agency.
The federally funded health care programs require custodial parents and non-parent relative caretakers of children who are requesting or receiving MinnesotaCare or Medical Assistance (MA) to assign their rights to medical support payments from the children's non-custodial parent. This means that the State of Minnesota is entitled to any medical support payments owed to people who are applying or eligible for health care program coverage.
People assign their rights to medical support by signing the application. People who refuse to assign their rights to medical support are ineligible for any Minnesota Health Care Program coverage whether it is federally or state-funded.
People who are not legally able to assign their rights to medical support, such as children and people under legal guardianship, are eligible even if the people who are legally responsible for them refuse to assign benefits.
Example:
Georgia applies for MA for herself and two children. She refuses to assign her and her children's rights to medical support by writing "refused" on the assignment portion of the application.
Action:
Approve MA for the children if they meet all other eligibility requirements. Georgia is ineligible for MA, GAMC, and MinnesotaCare (both federally and state-funded).
Example:
Lisa is 16 and lives with her six-month-old son and her mother Charlotte. There is a court order for Lisa’s father to provide medical support for her. Lisa is legally unable to assign rights for her own medical support as she is a minor.
Action:
If Charlotte requests health care program coverage for herself, require that she assign her own and Lisa's rights to medical support as a condition of her own eligibility. If Charlotte refuses, Lisa and the child are still eligible if they meet all other requirements.
Note: Lisa must provide information about her son's father and cooperate to the extent possible with attempts to establish paternity and medical support for him. See Minor Caretakers.
For Minnesota Health Care Program eligibility, caretakers are not required to assign their rights to child support or child care support payments. However, caretakers may request full child support enforcement services from the local county child support enforcement office, or IV-D agency.
Note: Caretakers must report any child support payments, whether court-ordered or voluntary. See Child Support Income.
If a caretaker does not cooperate with child support payment requirements, do not deny or close health care as long as the caretaker is cooperating with medical support enforcement.
For further information about medical support requirements and processes, see:
When to Refer for Medical Support.