5440            INDIVIDUAL UNDER 21 LIVING INDEPENDENTLY FROM PARENTS AND/OR SPOUSE

 

For an individual who does not live with his or her birth parents, adoptive parent(s), or spouse, only the individual's income and resources are used to determine his or her Medicaid eligibility.

 

When an Under 21 individual who is living independently in the community applies for Medicaid, the individual is coded FR and the Family Medicaid Adult Only standard (AI 01) is used in the eligibility determination.  When the individual is a minor who is not living independently but is in the care of a responsible adult or agency, the child is coded SC and the Family Medicaid Adult Not Included (ANI) need standard is used.  (For children in custody of the OCS , see Section 5195.)

 

Example:  

The household consists of a 19-year-old who is living with an unrelated friend.  Only the income and resources of the 19-year-old are considered when determining Medicaid eligibility.  The 19-year-olds countable income is compared to the Family Medicaid Adult Only (AI 01) standard.

 

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MC #42 (7/09)