*** The Health Care Programs Manual (HCPM) has been replaced by the Minnesota Health Care Programs Eligibility Policy Manual (EPM) as of June 1, 2016.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: December 1, 2006 |
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18.10 - Deeming Examples |
Archived: June 1, 2016 (Previous Versions) |
This section provides examples of income and asset deeming.
Family with Step Children Example.
Three Generation Household Example.
Christine applies for health care in May when she is three months pregnant. She is single and does not have other children. She is employed full time and $10,000 in a bank account.
Action:
She is found eligible for MA with a pregnant woman basis of eligibility based on her own income. Christine is exempt from an asset limit.
In July, Christine marries John. John’s daughter, Alexis (age two), also moved in with the new family. John is now requesting assistance for himself. He is employed part time and has $12,000 in a checking account.
Action:
Christine’s income is counted in John’s income calculation. John’s income is counted in Christine’s income calculation. Christine’s $10,000 asset total will count toward John’s asset total. Christine continues to be exempt from an asset limit.
Christine and John welcome their son, Adam, in November. John’s mother gives Adam a $5,000 savings bond to welcome him to the family!
Action:
Deeming for Christine and John continues. Adam is an auto newborn and will have eligibility without regard to income or assets until the month after his first birthday.
John requested his coverage closed in November for December because he started receiving health insurance through his employer. Christine’s postpartum period ends in January.
Action:
Continue to deem John’s income to Christine. John’s assets will begin to be deemed to Christine, and her own will also be counted toward her asset total, because she is no longer exempt from the asset limit.
Rebecca (age 20), her twin brother Randy, and their sister, Margo (age 24), apply for health care together. They share a home and do not live with their parents. They are all working and each have a $2,000 savings bond.
Action:
Do not deem income to determine any of the siblings’ eligibility. Only Margo has an asset test and only her own assets will be counted toward her asset total.
Family with Step Children Example
Kelly, age 30, lives with her husband Jason, age 33. Kelly’s daughter, Allie, age eight, and Jason’s son, Garrett, age 10, live with them. Both Kelly and Jason are employed. Allie’s father is paying child support to her. Kelly and Jason have a joint checking account, and Jason has a $1,000 CD. They are all applying for health care and are found eligible for MA.
Action:
Deem Jason’s income to Kelly and Kelly’s income to Jason because they are married. Deem Kelly’s assets, half of the joint checking account, to Jason. Deem Jason’s assets, half of the joint checking account and his CD, to Kelly.
Deem Jason’s income to his son, Garret. Deem Kelly’s income to her daughter, Allie. Both Garrett and Allie are exempt from an asset limit.
Note: Had the family been found eligible for MinnesotaCare, the household income would be calculated using all income from all household members. The asset total would be calculated using only Jason’s and Kelly’s assets. The children would continue to be exempt from an asset limit.
Three Generation Household - Waiver Example
Megan (age 18) and her son Trevor (age two) live with Megan’s parents, Sue and Larry, and Megan’s sister Laura (age 15). Megan’s mother receives RSDI and is on the CADI waiver. Megan’s dad works full time. Her parents have joint assets totaling $1,200. Neither Megan nor Laura is an emancipated minor. Megan works part-time.
Action:
Do not deem Larry’s income or assets to Sue. Because she is on the CADI waiver only her income and assets will be used to determine her eligibility.
Deem Sue’s income and assets to Larry.
Deem Sue and Larry’s income to both Megan and Laura. The girls are exempt from an asset limit.
Deem only Megan’s income to Trevor. He is also exempt from an asset limit.
Jane and Jake are married and eligible for MA. Both are age 46, and disabled. Jake entered a Long-Term Care Facility (LTCF) on June 4 and is not expected to be discharged.
Action:
Jane and Jake will deem their assets and income to each other for the month of June. Jake is removed from Jane’s MA household effective July 1. Therefore, Jake’s eligibility will only be determined by using his own income and assets, and Jane’s eligibility will be determined using her own income and assets.
On July 15th, June receives an inheritance of $35,000.
Action:
June is ineligible for MA due to excess assets. Remember we are only counting her assets for her own eligibility. The inheritance does not affect Jake’s eligibility.
Annie and Henry are married. Annie is pregnant with twins and works a part-time job. Henry is disabled and receives RSDI and SSI. Annie’s income was considered in determining Henry’s SSI benefits. Annie owns a savings account and Henry owns a checking account.
Action:
Deem Henry’s income to Annie, and Annie’s income to Henry. Keep in mind that Henry’s SSI income will be excluded from Annie’s income calculation, and that all income considered in determining Henry's SSI will be excluded from Henry’s income calculation. Deem Annie’s assets, the savings account, to Henry. Annie is exempt from an asset limit.