*** The Health Care Programs Manual (HCPM) has been replaced by the Minnesota Health Care Programs Eligibility Policy Manual (EPM) as of June 1, 2016.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. ***
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Effective: May 1, 2013 |
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Archived: June 1, 2016 (Previous Versions) |
When calculating income and asset totals for an individual to determine his or her eligibility for a health care program, it is often necessary to count another person’s income or assets in that determination. This is known as deeming. This chapter provides deeming policy, including sponsor deeming, for each health care program.
Medicare Savings Programs Income and Asset Deeming.
MinnesotaCare has a household income total and all household members’ countable income is considered when calculating that total.
For more information on countable income, excluded income or income calculations see Income.
For more information on three-generation households, see Household Composition.
MinnesotaCare has a household asset total which is the countable value of assets owned by all members in the household who are age 21 or older.
For more information on countable assets, jointly owned assets, excluded assets, determining the asset value and exemptions to the asset limit, see Assets.
Income deeming requirements are not the same as household composition rules. People may be counted in a client’s household size without having their income counted in the client’s income calculation.
Determine whose income deems to a person separately for each client. In general, deem the income of the following people to the client, when they live with the client:
l The client’s spouse.
Note: When a client is not divorced but is legally separated from his/her spouse, and continues to live in the same household, deem the spouse’s income to the client.
Exceptions: Do not deem a spouse’s income to the other spouse, if:
n The spouses live apart for reasons other than temporary absence .
n The client is on MA-EPD .
n The client was on MA-EPD for 24 consecutive months before the month in which the enrollee turns age 65 and there has not been a break in basic MA coverage of more than one calendar month.
Note: For MA-EPD clients turning age 65 in 2012 or 2013, the person is required to have been on MA-EPD for 20 months out of the 24 consecutive months before the month of the enrollee's 65th birthday.
n The client is on the CADI, CAC, DD, or BI waivers.
l The client’s parent, whether biological or adoptive, and regardless of the parent’s age, if the client is under 21 years old and not emancipated.
Note: When the father, or alleged father, is not married to the child’s mother, deem the father’s income only if the father lives with the child and paternity has been established.
Exceptions: Do not deem a parent’s income to the child if the child is:
n A blind or disabled child ages 18 to 21.
n An auto newborn. Do not deem from birth through the end of the month of the child’s first birthday.
n On MA-EPD and age 18 or older, and lives with one or both biological or adoptive parents.
n On TEFRA and is not eligible when parental income is deemed.
n On the CADI, CAC, DD, or BI waivers.
Do not deem income from:
l A child to a parent.
l A sibling to another sibling, or other children under 21 living in the household.
l A stepparent to a stepchild.
l A grandparent to a grandchild.
l A non-parent relative caretaker to a child.
l Other people to a client who has automatic MA or other deeming exceptions.
MA-LTC, including EW, has unique rules for when deeming of income begins and ends for that program. Please see MA Payment of Long-Term Care (LTC) Services for more information.
Asset deeming requirements are not the same as household composition rules. People may be counted in a client’s household size without having their assets counted in the client’s asset total.
Note: Keep in mind that a child under 21 years old has an asset limit exemption and therefore no assets are deemed to a child.
Determine whose assets deem to a person separately for each client.
Deem the assets of the client's spouse when they live with the client.
Note: When a client is not divorced but is legally separated from his/her spouse, and continues to live in the same household, deem the spouse’s assets to the client.
Exceptions: Do not deem spousal assets for the following:
n An MA-EPD client. This includes the spouse’s share of jointly held assets.
n A client was on MA-EPD for 24 consecutive months before the month in which the enrollee turns age 65 and there has not been a break in basic MA coverage of more than one calendar month.
Note: For MA-EPD clients turning age 65 in 2012 or 2013, the person is required to have been on MA-EPD for 20 months out of the 24 consecutive months before the month of the enrollee's 65th birthday.
n A client on the CADI, CAC, DD, or BI waivers.
Do not deem assets from:
l A child to a parent.
l An adult sibling to another adult sibling.
l Another person to a client who meets an asset limit exemption.
Medicare Savings Programs Income and Asset Deeming
Deem the income and assets following standard MA deeming guidelines when the household member lives with the client and is counted in the client’s household size.
Example:
Sue applies for EW and is eligible for Medicare. She lives with her husband Greg.
Action:
Determine Sue’s eligibility for the Medicare Savings Programs using a household size of one. Since Greg is not included in Sue’s household size, do not deem Greg’s income and assets in Sue’s eligibility determination.