WAG 18-05-06

A family that is receiving TANF or Family Assist may be able to keep receiving medical benefits under extended medical when their income exceeds the income standard.

revised textTo receive extended medical, the family must have received TANF or Family Assist in 3 of the last 6 months. Additionally, the family must have lost eligibility for TANF or Family Assist because of:

  • earnings (includes failure to respond to the New Hire List), or
  • spousal support.

If a family lost eligibility for some other reason, they do not qualify for extended medical. The person who is working, or who receives the spousal support, has to be a parent or caretaker relative in the deleted textTANF unit, or received benefits as a parent or caretaker relative under Family Assist. The earnings can be from a new job or an increase in pay from an ongoing job.

Start counting the extended medical with the first month the family should have stopped receiving TANF or Family Assist. This will be the month action could have been taken had the earnings or spousal support been reported and a timely notice of change provided. Use this month as the first month of the extended medical.

Extended Medical due to Earnings or the New Hire List

A family can receive extended medical up to 12 months. An eligible family receives an initial 6 months of extended medical and can then receive an additional 6 months if they:

  • complete and return all necessary forms; and
  • still have a child at home who was included in the first 6-month extension; and
  • have earnings that are less than revised text185% of the federal poverty level using MAGI budgeting policy (see the MAGI Budgeting policy memo); and
  • have not quit work without good cause.

If the extended medical ends during the 12-month period, any person under age 19 remains eligible under Continuous Eligibility (see PM 18-05-01).

Extended Medical due to Spousal Support

new text

Adults in the family can receive extended medical up to 4 months. Persons under age 19 remain eligible under Continuous Eligibility.

new textSpousal support (or alimony) is income received by a person from their spouse or former spouse under a divorce decree or written separation agreement that is specifically for the support or maintenance of the other spouse.

new textNote: IES will be programmed to generate a REDE notice before adults reach the 4 month limit. Until IES Phase 2 is implemented, FCRC staff must alert the Medical Extension Unit (MEU) when a case is authorized extended medical due to the receipt of spousal support. MEU must set a control to determine whether the adult is eligible under another program, or must be canceled after the 4 month period.