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Effective: December 1, 2006 |
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03.25.35.05ar1 - Potential Eligibility for TMA and TYMA (Archive) |
Archived: July 1, 2008 |
One eligibility requirement for a TMA or TYMA basis of eligibility is to have met certain criteria for at least three of the previous six months. This requirement is referred to as "potential eligibility."
Criteria for Potential Eligibility.
When to Act on Potential Eligibility.
Criteria for Potential Eligibility
To have potential eligibility for TMA/TYMA for a given month, the person must meet all of the following conditions:
l Does this person have a Method A basis of eligibility (even if currently MA-eligible using a Method B basis)?
l Is this person one of the following:
n A parent or relative caretaker with a dependent child in the household?
n A dependent child with a parent or relative caretaker in the household?
n A pregnant woman in her third trimester?
Note: It is not necessary that all household members be on MA, although only those on MA will be potentially eligible for TMA/TYMA.
l Is this person's net countable income equal to or less than 100% FPG using Method A deeming and income computation rules?
If the answer to all three questions is "yes," flag that month as one in which that person has met the potential eligibility criteria for a future TMA/TYMA basis of eligibility. This includes those who use Method B for their current eligibility.
When to Act on Potential Eligibility
Determine actual eligibility for TMA or TYMA if a person who meets the potential eligibility criteria in at least three of the previous six months later loses MA Method A eligibility due to one of the following:
l Increased child or spousal support.
l The caretaker's increased earned income or loss of the earned income disregard.
Example:
Anthony and Karen apply for MA with Karen's daughter Melissa, age two. Anthony is Melissa's stepfather, and does not have an MA basis of eligibility. Karen has a Parent/Caretaker basis, and Melissa is a dependent child with a Children Under 21 basis.
Action:
Flag Karen and Melissa for potential TMA/TYMA eligibility if they have income at or below 100% FPG using Method A deeming, disregards and deductions. Anthony is not potentially eligible for TMA/TYMA.
Example:
Ron and Cathy apply for MA with their daughter, Christina, age five. Ron is disabled. Cathy is working. Ron, Cathy and Christina all have an MA Method A basis: Ron and Cathy both have a parent/caretaker basis, and Christina is a dependent child with a Children Under 21 basis. However, Ron also has a Method B basis as a disabled person, which he has chosen to use for his current MA eligibility.
Action:
Flag all three household members for potential TMA/TYMA if each person’s countable income using Method A deeming, disregards and deductions is at or below 100% FPG.
For further information on how to determine TMA/TYMA eligibility, see:
Transitional MA/Transition Year MA (TMA/TYMA).
Concurrent Eligibility for TMA/TYMA.
Reporting Requirements for TYMA.