*** The Health Care Programs Manual (HCPM) has been replaced by the Minnesota Health Care Programs Eligibility Policy Manual (EPM) as of June 1, 2016.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. ***
Effective: November 1, 2012 |
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17.10 - Determining Household Size for MinnesotaCare |
Archived: June 1, 2016 (Previous Versions) |
Calculate the MinnesotaCare household size by determining:
l who lives together.
l the relationships between the people who live together.
l who must be in a MinnesotaCare household together.
Once the MinnesotaCare household is established, determine who in the household must apply for MinnesotaCare based on the All or Nothing Rule.
MinnesotaCare Household Exceptions.
People with parental and marital relationships are in the same MinnesotaCare household, which determines the household size.
l See Non-Parent Caretaker for instructions on determining the household size when foster parents, relative caretakers and guardians apply for children in their home.
Include people who have the following parental and marital relationships to other people living with them in a MinnesotaCare household:
l Parental Relationship.
n Parent and Stepparent.
Note: A stepparent is always included in a stepchild’s household size, even if the biological or adoptive parent is not in the home.
Example:
George and Martha are a married couple. George’s 13-year-old son and Martha’s nine-year-old daughter, Sarah, both live with them.
Action:
George and Martha have a marital relationship. They each have a parental relationship with their children. They are all four in a MinnesotaCare household together. They all have a household size of four.
Martha moves out of the household, but her daughter remains in the care of George.
Action:
Continue to include Sarah in George's and his son’s MinnesotaCare household because George is still her stepparent. The household size is three.
l Children (birth to 21).
n Children must live in the household at least 50% of the time to be included in the household, except in the case of temporary absence. Base determination of a child’s home on current circumstances. Use the custody information from a court order only in contested cases.
Example:
John and his daughter Martha enroll in MinnesotaCare. Martha’s mother, June, applies and lists Martha as living in her home. June provides a court order showing that she has physical custody of Martha and that Martha is not in John’s home at least 50% of the time.
Action:
Advise John that you have information showing that Martha does not live in his home at least 50% of the time and Martha will be removed from his case.
Count Martha as a member of June’s household until the court order is changed or both parents agree in writing that Martha’s living situation has changed. Do not require either parent to go to court as a condition of eligibility.
n In cases where custody alternates equally between parents, the child can be counted in the household of each parent; however the child can only be enrolled in one household. Allow the parents to choose which household will enroll the child.
Example:
Marvin and Joan are divorced and have joint custody of their daughter Becky. Becky alternates living with Marvin one week and with Joan the next. Time in each household is exactly equal throughout the year. Joan and Marvin each apply for MinnesotaCare.
Action:
Count Becky in each household size because she is a part of both households. Allow Marvin and Joan to choose with which household Becky will receive coverage.
n Adopted children are members of the household beginning on the first day of the month in which they are placed for adoption.
Example:
Bohde is married to Sonia. They have adopted 10-month-old triplets.
Action:
Bohde and Sonia have a marital relationship. They both have a parental relationship to the triplets. They are one MinnesotaCare household with a household size of five.
l Marital Relationship: Two people who are married have a marital relationship. See Household Composition for more information on marriage.
Example:
Lester and Leona are living together but are not married. Lester and Leona are each their own MinnesotaCare household with a household size of one. Lester finally talks Leona into getting married!
Action:
Lester and Leona now have a marital relationship and are in the same MinnesotaCare household. Redetermine eligibility with a household size of two at the next renewal. Lester and Leona can request to be included in the same household prior to renewal.
l Two people in a household who each have a parental or marital relationship to a third household member will be in the same household, even if they do not have a parental or marital relationship with each other. They are all included in the same MinnesotaCare household.
Example:
Bob and Sue, an unmarried couple, live with their seven-year-old daughter, Beatrice.
Action:
Include Bob and Sue in the same MinnesotaCare household because both have a parental relationship to Beatrice. They all have a household size of three.
Example:
Marsha lives with her two minor children and her friend Tim, who is not the children's father.
Action:
Marsha has a parental relationship with her children. Marsha and her children are a MinnesotaCare household and have a household size of three.
Tim does not have a parental or marital relationship with anyone in the household. Tim is his own MinnesotaCare household with a household size of one.
l Include an unborn child in the pregnant woman’s household size. If the pregnant woman is married, the woman, her husband and the unborn child are all included in the same household.
Note: Include more than one unborn child in the household size if the multiple pregnancy is verified.
Example:
Sasha and Salim, a married couple, live together and are expecting a child. They do not anticipate a multiple birth.
Action:
Sasha and Salim have a marital relationship. Sasha and Salim are one household with a household size of three.
Example:
Debra and Mark, an unmarried couple, live together and are expecting a child. They do not anticipate a multiple birth.
Action:
Debra and Mark do not have a marital relationship. Mark will not have a parental relationship until the baby is born and paternity is established. Debra is a MinnesotaCare household on her own with a household size of two. Mark is a separate MinnesotaCare household with a household size of one.
See Enrollee Becomes Pregnant for more information.
MinnesotaCare Household Exceptions
The following are exceptions from standard MinnesotaCare household size policies:
l Three-Generation Households. These are households with a grandparent, minor parent and minor parent’s child in the same living situation. There are special steps to determine household size of a Three-Generation Household which are outlined in this chapter.
l Emancipated minors. The emancipated minor, the emancipated minor's spouse and their children must be separate households from the minor's parents and siblings.
Example:
Ann, age 17, her husband Steve, and their son Mark live with Ann's parents.
Action:
Ann and Steve have a marital relationship, which makes Ann an emancipated minor. They have a parental relationship with Mark. Ann, Steve and Mark are a MinnesotaCare household together and have a household size of three.
Ann’s parents, who have a marital relationship, are their own MinnesotaCare household. They each have a household size of two.
l Children age 21 or older, even if they are financially dependent on the parents they live with, are not counted in the parent’s household.
Example:
Katie, age 22, lives with her parents. Katie is in college. Her parents still claim her as a dependent for tax purposes because they are supporting her while she is in school.
Action:
Katie is a MinnesotaCare household of her own, despite living with her parents and being financially dependent on them. She has a household size of one.
Katie’s parents have a marital relationship and are in a MinnesotaCare household together. They have a household size of two.
l Children in secure juvenile detention facilities, state-owned and operated juvenile facilities and county-owned and operated secure juvenile facilities are not included in the MinnesotaCare household of their parents or siblings.
Exception: Children already enrolled in MinnesotaCare may remain part of the MinnesotaCare household until the next renewal.
l People incarcerated in correction or penal institutions and government controlled halfway houses are not included in MinnesotaCare households even if there was a marital or parental relationship.
Exception: Enrollees who are incarcerated may remain part of the household until the next renewal.
l Relatives age 18 or older, who would be a relative caretaker but because the minor child’s biological or adoptive parents, stepparents, or guardians also live in the home they do not have primary responsibility for a minor child. These relatives are not included in the MinnesotaCare household of the child. See Non-Parent Caretaker for more information.
Example:
Betty and her minor child Mark live with Mary, who is Mark's aunt. Mary has taken over Mark’s caretaking and pays all his bills, so that Betty can focus on playing in a rock band.
Action:
Betty has a parental relationship to Mark and lives in the household, therefore Mary cannot be Mark’s relative caretaker. Betty and Mark are a MinnesotaCare household together with a household size of two.
Mary is a separate MinnesotaCare household with a household size of one.
l Foster children are not included in a foster parent's household, unless placed in the home for adoption or the foster parents choose to include the foster children in their household. For more info on foster children see Non-Parent Caretakers.
Example:
Louis has been placed in the Johnson household as a foster child. This is not an adoptive placement. Louis receives MA and the Johnsons do not wish to apply for MinnesotaCare for him.
Action:
Louis is not part of the Johnson's MinnesotaCare household or in their household size.
l Do not include other household members in the household size of a child applying for or enrolled in MinnesotaCare for Certain Children Exiting Foster Care or a Juvenile Residential Correctional Facility. These children are a household size of one. Count the child as a household member following standard MinnesotaCare guidelines when determining eligibility for other household members.
Example:
Brandon, age 19, lives with his parents. Brandon and his parents apply for MinnesotaCare on November 1. Brandon was released from a juvenile residential correctional facility on August 1. He resided in the facility on his 18th birthday.
Action:
Consider Brandon to be a MinnesotaCare household of his own, despite living with his parents. He is a household size of one.
Consider Brandon as part of his parents' household size. Brandon's parents have a marital relationship to each other and a parental relationship to Brandon. Brandon's parents' household size is three.
l The household for MinnesotaCare Volunteer Firefighters and Ambulance Attendants consists only of the applicant or enrollee.