*** The Health Care Programs Manual (HCPM) has been replaced by the Minnesota Health Care Programs Eligibility Policy Manual (EPM) as of June 1, 2016.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: June 1, 2012 |
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18.05 - Sponsor Deeming |
Archived: June 1, 2016 (Previous Versions) |
Certain noncitizens have a sponsor whose income and assets must be deemed to them when they are applying for health care. This section provides information on how to determine if a noncitizen has a sponsor, whether the noncitizen is exempt or excluded from sponsor deeming, and how to verify the identity of the sponsor.
Do not apply sponsor deeming when determining:
l MA eligibility for noncitizen children under age 21 or noncitizen pregnant women.
l MinnesotaCare eligibility for households in which a pregnant woman or child under age 21 is applying for or enrolled in MinnesotaCare.
For general sponsor deeming policy, as well as policy for a specific program, see Sponsor Deeming Program Provisions.
Steps to Determine Sponsor Deeming.
Sponsor Deeming for Emergency Medical Assistance (EMA).
Steps to Determine Sponsor Deeming
Follow these steps to determine if sponsor deeming applies:
1. Determine if the noncitizen has a sponsor.
2. Determine if the noncitizen meets an exception from sponsor deeming. If there is no exception, continue to the next step.
3. Request verification of sponsorship and obtain a release of information to contact the sponsor.
4. Determine and verify the sponsor’s countable income and assets that will be deemed to the noncitizen following sponsor deeming program provisions.
United States Citizenship and Immigration Services (USCIS) determines if a person meets the criteria to be a sponsor, and whether a noncitizen needs a sponsor to enter the U.S. Do not deem the sponsor’s income or assets if a client is sponsored using a form other than USCIS form I-864, Affidavit of Support.
There are a number of ways to determine if a client is sponsored:
l For clients who have a Lawful Permanent Resident (LPR) status and entered the U.S. or adjusted their status on or after December 19, 1997, check for USCIS form I-864, Affidavit of Support.
l Also check for family-based codes for LPRs on their I-551 immigration card. If they have one of these codes, it is likely they have a sponsor.
l Use SAVE to request specific sponsorship data for clients who are not able to provide sponsorship information.
Some people are not required to have sponsors. The following noncitizens are not required to have a sponsor:
l Refugees.
l Asylees.
l Immigrants sponsored by a business or organization which has no relation to the immigrant.
Example:
The local Russian church sponsors 12 people from Russia.
Action:
Do not deem income and assets of the church to the immigrant.
Sponsored noncitizens are considered "sponsored" until the sponsor or the sponsored noncitizen dies, or until the sponsored noncitizen:
l Becomes a naturalized citizen.
l Leaves the United States permanently.
l Earns or can be credited with 40 qualifying work quarters, or work credits.
Note: It takes 10 years to accumulate 40 work quarters. However, quarters worked by a noncitizen’s spouse during their marriage, or by a noncitizen’s parent while the noncitizen was under age 18, count toward the 40 qualifying work quarters.
Information about work quarters is available on the SDX State Data Exchange (SDX) between the Social Security Administration and MAXIS or on a person’s Social Security statement. Social Security sends an annual statement that shows whether or not the person has earned enough work credits (40) to qualify for retirement benefits. The statement will show the person is not eligible for Social Security if the person has not earned 40 credits. Clients can request a Social Security statement by contacting SSA or online at SSA.gov. This web site also provides further information about how credits are earned and the required amount of earnings for the current year.
Example:
Shawn, age 28, entered the United States 12 years ago. He was sponsored by his father. Shawn is applying for health care because he lost his job. Shawn tells his worker that he does not want to bother his father about sponsor deeming. Shawn could have 40 qualifying work quarters or credits because he has been in the United States for over 10 years, but his Social Security statement shows he has only 30 work quarters. However, Shawn’s father earned enough work credits before Shawn turned 18 to make up the difference.
Action:
Do not deem income and assets from Shawn’s sponsor (his father). Shawn is exempt from sponsor deeming because he has enough qualifying work quarters or credits.
There are a number of exceptions to deeming income and assets from a sponsor to a client.
l Children under 21.
a. Do not apply sponsor deeming when determining MA eligibility for noncitizen children under the age of 21. Do not require a copy of the Affidavit of Support or verification of sponsor income or assets. Apply all other MA eligibility criteria following standard policy.
This exception ends when the child turns 21. When redetermining eligibility prior to the child’s 21st birthday, require a copy of the Affidavit of Support unless the 21-year-old meets another sponsor deeming exception. Begin deeming sponsor’s income and assets effective the month following the 21st birthday.
b. Do not apply sponsor deeming when determining MinnesotaCare eligibility for households that include one or more children under the age of 21 who are applying for or enrolled in MinnesotaCare. Do not require a copy of the Affidavit of Suport or verification of sponsor income or assets. Apply all other MinnesotaCare eligibility criteria following standard policy.
This exception ends when there is not a pregnant woman in the MinnesotaCare household and:
m the only child in the household turns 21.
When redetermining eligibility prior to the child's 21st birthday, require a copy of the Affidavit of Support from the household member who is the sponsored noncitizen. Move the 21-year-old to his or her own case. Begin deeming sponsor's income and assets for the household with the sponsored noncitizen effective the month following the child's 21st birthday unless there are other children or a pregnant woman in the household or another exception is met.
m all children in the MinnesotaCare household leave the home permanently.
Count sponsor income and assets for the parent or parents effective the month following the month the child leaves or is removed from the home.
Example:
Twenty-year-old Jolanta lives with her parents, Tanek and Carol. All three entered the United States in November 20, 2009, as lawful permanent residents under the family preference visa category and were sponsored by Tanek's brother. Jolanta and her parents apply for MinnesotaCare on January 10, 2012. They meet all MinnesotaCare eligibility criteria.
Action:
Do not apply sponsor deeming when calculating household income because Jolanta is a child under age 21 who is a part of the household. Do not request Affidavits of Support or verification of sponsor income or assets. Jolanta is eligible for major program LL because she is a lawfully present noncitizen under age 21. Her parents are eligible for major program JJ because they have lived in the United States for less than five years.
On June 14, 2012, Jolanta turns 21. Jolanta has no income of her own and meets all other MinnesotaCare eligibility criteria. She would like to be considered for ongoing MinnesotaCare on her own case.
Action:
Close MinnesotaCare for Jolanta on her parent's case effective June 30. Follow current policy and procedures to establish and approve eligibility on a new MinnesotaCare case for Jolanta. Review the most recent application or renewal on file to determine whether she may qualify for MA for adults without children or ongoing MinnesotaCare. Because Jolanta is now age 21 and is a sponsored noncitizen, her uncle's sponsor income and assets must be considered when determining her ongoing eligibility. Request a copy of her Affidavit of Support as well as verification of sponsor income and assets. Redetermine MinnesotaCare eligibility for Jolanta's parents beginning in July. Request copies of the Affidavits of Support and verification of sponsor income and assets. If Tanek and Carol remain eligible for MinnesotaCare, recalculate their MinnesotaCare premium and approve MinnesotaCare.
l Pregnant Women.
a. Do not apply sponsor deeming when determining MA eligibility for noncitizen pregnant women. Do not require a copy of the Affidavit of Support or verification of sponsor income or assets. Apply all other MA eligibility criteria following standard policy.
This exception ends when the sponsored pregnant woman’s 60-day postpartum period ends. When redetermining eligibility prior to the end of the pregnant woman’s postpartum period, require a copy of the Affidavit of Support unless she meets another sponsor deeming exception. Begin deeming her sponsor’s income and assets effective the month following the end of the postpartum period.
Example:
Serafina applies for health care on December 2, 2010, and is requesting retroactive coverage for November 2010. She is 29 years old and is five weeks pregnant. She submits her green card as verification of her immigration status and reports that her father is her sponsor. Her green card indicates she entered the U.S. on February 6, 2009, and has LPR status with a family-based immigrant code. Serafina meets all other MA eligibility criteria and does not have other health insurance.
Action:
Approve MA with FFP (MA/PX) effective November 2010. Do not request a copy of the Affidavit of Support or verification of Serafina’s sponsor’s income and assets. At the end of the 60-day postpartum period, sponsor deeming rules will apply. Upon notification of birth, request a copy of the Affidavit of Support and Serafina’s sponsor’s income and assets. Redetermine eligibility for Serafina prior to the end of the postpartum period.
b. Do not apply sponsor deeming when determining MinnesotaCare eligibility for households that include a pregnant woman. Do not require a copy of the Affidavit of Support or verification of sponsor income or assets. Apply all other MinnesotaCare eligibility criteria following standard policy.
This exception ends when:
m the pregnant woman's 60-day postpartum period ends, the child does not remain in the home after the birth and there are no other children in the household.
When redetermining eligibility prior to the end of the pregnant woman's postpartum period, require a copy of the Affidavit of Support unless another sponsor deeming exception is met. Begin deeming the sponsor's income and assets effective the month following the end of the postpartum period.
m the pregnant woman fails to submit verification of pregnancy within 60 days after a request is sent.
Count sponsor income and assets in the household income total effective the next available month. If the pregnant woman later submits proof of pregnancy, approve MinnesotaCare under pregnant woman status and recalculate household income without sponsor income back to the month of conception or the effective date of coverage, whichever is later.
l Facility Placement.
Do not deem sponsor’s income or assets if the noncitizen needs placement in a facility and placement is jeopardized by the sponsor’s failure or inability to provide support, or inability of the client to locate the sponsor.
n Count only the income the sponsor and/or sponsor’s spouse actually contributes to the noncitizen.
n Require the client to explain why the sponsor is not providing support.
l Battery or Extreme Cruelty.
A deferment of sponsor deeming can be approved for 12 months if a noncitizen has been battered or subjected to extreme cruelty.
n Count only income the sponsor or sponsor’s spouse actually contributes to the noncitizen and his or her children.
n The deferment can be extended an additional 12 months if all of these conditions are met:
m The noncitizen or children continue to have a need related to the battery.
m They have either an order for protection or a USCIS determination.
m The sponsor is the batterer.
To meet this exception the noncitizen or his or her children must have one of the following:
n A battered noncitizen status granted by the USCIS.
n A determination by the county or MinnesotaCare operations that the noncitizen or his or her children have been battered or subjected to extreme cruelty. This requires a statement of abuse from the client or other documentation such as:
m Police, government or court records.
m Statement from a battered women’s shelter staff or sexual assault or domestic violence advocate with knowledge of circumstances or credible evidence that supports a sworn statement.
m Statement from a professional from whom the client has sought assistance about the abuse.
m A sworn (notarized) statement from any other person with knowledge of the circumstances or credible evidence that supports the sworn statement.
The noncitizen or his or her children must also meet both of the following conditions:
n They are not living with the batterer.
n There is substantial connection between the need resulting from the battery and the need for coverage through the health care programs.
Do not consider sponsor income or assets when determining eligibility for EMA.
Clients whose immigration status indicates they have a sponsor must cooperate with supplying or obtaining sponsor information unless they meet a sponsor deeming exception. The sponsor must also cooperate. Deny or close coverage if the client or sponsor does not cooperate with providing or obtaining sponsor information.
For noncitizens whose immigration status indicates there is a sponsor:
l Request a copy of the Affidavit of Support from the client.
l Follow these steps to find out if there is a sponsor and the sponsor’s identity if the client is unable to supply a copy of the Affidavit of Support, or the client appears to be subject to sponsor deeming but claims not to have a sponsor:
1. Request Affidavit of Support data using SAVE:
Note: Do not use SAVE if the client has not submitted proof of immigration status.
a) In SAVE, select the Request Additional Verification link and check the ”Request Affidavit of Support Data” box prior to submitting the request.
b) The response in SAVE will include the following sponsor information if the individual was sponsored using I-864, Affidavit of Support:
r First, middle, and last name(s).
r Social security number(s).
r Last known address including street, city, state and zip code.
Note: Sponsor deeming rules do not apply if SAVE indicates that the individual was not sponsored using the I-864, Affidavit of support.
c) Follow the steps below if the sponsor information is incorrect in SAVE.
2. For agencies that do not use SAVE or if the sponsor information in SAVE is incorrect and follow-up is needed, obtain a release of information from the client to contact USCIS directly:
a) Complete a Document Verification Request form (USCIS G-845). This form is available online at the USCIS website (www.uscis.gov) and must be reproduced as a two-sided document.
b) Complete a Document Verification Request Supplement form (USCIS G-845 Supplement). This form is not available online but may be requested from the USCIS Forms Request Line at (800) 870-3676. This form must be reproduced as a two-sided document.
c) Send completed forms to:
U.S. Citizenship and Immigration Services
10 Fountain Plaza, 3rd Floor
Buffalo, NY 14202
Attn: Immigration Status Verification Unit
l Obtain a release of information from the client prior to contacting the sponsor to request income and asset verification.
Upon receipt of the release of information, send the sponsor the Sponsor Letter (DHS-3453). This form reminds the sponsor of the legal obligation to provide support and requests verification of the sponsor’s and the sponsor’s spouse’s income and assets.
n Do not send the Sponsor Letter if the immigrant is exempt from the deeming requirement under a battered status and the sponsor is responsible for the battery.
n Do not request verification of assets if the client is exempt from the asset limit.
n Deny or close health care program coverage if the sponsor and the sponsor's spouse fail to respond to the Sponsor Letter or fail to provide verification. Consider whether the client is eligible for EMA.
Reported changes should be acted upon for the next available month allowing for timely notice. Changes that may impact eligibility for the sponsored client include, but are not limited to:
l Immigration status.
l Living arrangement with sponsor changes.
l Sponsor income or asset changes.
Note: Some income changes will not affect MinnesotaCare eligibility for the next available month.
l 40 qualifying work quarters are attained.
l Client qualifies as a battered noncitizen.
l The sponsor or the sponsored noncitizen dies.
Do not apply sponsor deeming provisions for EMA. Follow standard MA guidelines for deeming income and assets.
Example:
Maria is a 49-year-old noncitizen subject to the sponsor deeming provisions. She is hospitalized and applies for health care. She is certified as disabled by the State Medical Review Team (SMRT). Her medical condition also qualifies as an emergency medical condition. Maria has current health care coverage that is a barrier to MinnesotaCare eligibility.
Action:
Determine eligibility for EMA based on the information Maria provides. Do not require Maria to verify immigration status. Do not require Maria to comply with sponsor deeming requirements. Determine eligibility for MA with FFP or NMED only if Maria chooses to provide the necessary information.
Note: If Maria is eligible for NMED, EMA should still be used for services that qualify for EMA coverage.
There is no income limit for MA-BC and CVT. Therefore, do not apply sponsor deeming provisions when determining eligibility under these eligibility bases.