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Ineligible household members include individuals such as stepparents and the parent(s) of a minor parent.

Policy requires that a portion of the income of a stepparent or parent(s) of a minor parent be counted in the eligibility determination, but their needs are not included in the household size.  The Non-Household Member Deduction (NOMD) screen is used to code allowable deductions for these individuals.

Stepparents & Deemed Parents

  • Allowable deductions are entered on the NOMD screen after the stepparent’s or deemed parent’s name
  • Enter an S by any stepparent dependent or D by any deemed parent dependent in the DEPENDT column on the NOMD screen
  • EIS counts a portion of the their income based on the budget code used on the MIBW screen (ST or DP)
  • The needs of ineligible individuals will not be considered in the household size.

Example:

It is January 11, 2008 and Mom Codez is applying for Family Medicaid for herself, her husband, her daughter and her stepchild.  Mom’s family consists of:

  • Her husband Stepdad Codez
  • Mom’s son MChild Denez
    Mom’s stepdaughter Stepchild Codez
  • On the application Mom reports the following income, and expenses:
  • Stepdad’s gross monthly wages $1500
  • Mom’s gross monthly wages $700 + UIB $200
  • Stepdad pays $100 in monthly child support to his ex-wife for another child, and $50 for additional out of home support payment.

Since the stepparent cannot be included in the Family Medicaid case as a household member, he and his child are coded “OU” on the SEPA. The caseworker must complete an eligibility determination for Mom and MChild.

Step 1:

On the SEPA:

  1. Code Mom and MChild  IN
  2. Code Stepdad & Stepchild  OU

Step 2:

  1. Fill out all Medicaid Application Entry Sequence screens in order through the SEEI screen.

Step 3:

  1. <NEXT> to the NOMD and enter Stepdad’s child support and the out of home support payment information.
  2. Enter S in the DEPENDT field for Stepchild

Step 4:

  • <NEXT> to the MIBW

On the MIBW:

  1. In the CLIENT ## field type Mom’s client number 01 <ENTER>
  2. <TAB> to the CATEGORY field and type the category FM (Family Medicaid)
  3. <TAB> to the THRU MO field and type the six-month review date 0608
  4. <TAB> to the BUD/GET field and enter the appropriate budget codes for each individual FR (Financially responsible) for Mom, ST (Step Parent) for Stepdad, CH (Child) for MChild.  Do not enter a budget code for the Stepchild.
  5. <PF5> Mom is eligible for Family Medicaid
  6. In the CLIENT ## field enter MChild’s client number 03 <ENTER>
  7. <PF5> to determine eligibility (If Mom is eligible, her child will also be eligible – the budget coding will remain the same for this scenario.)

Note 1: If a child is initially found ineligible for Family Medicaid because of stepparent or grandparent deeming, the child’s eligibility must be redetermined excluding the need, income and resources of the stepparent, or grandparent.  This means that for the child’s eligibility determination Mom would be coded FR, there would be no ST coding for Stepdad, and MChild would be coded CH.  Also, Mom would be coded OU on the SEPA.

Note 2: If a parent is a Deemed Parent, enter the code DP in the BUD/GET field

 


Step 5:

  • <NEXT> to the MIAU and authorize

See page 48 and 49 of EIS Procedure 2003-2, Denali KidCare, Under 21, Emergency Medical Treatment for Aliens, Family Medicaid, and Transitional Medicaid Processing for more details.  Also, refer to Family Medicaid Manual section 5160-14 and Online Help (PF10) for additional guidance and tips. 

Policy, SD&T and Systems Operations