See policy memorandum dated 12/11/13 Family Health Spenddown Ending for Non-Pregnant Adults.
Set up one Assist case for the parent(s) and the children whose income does not affect the All Kids/FamilyCare Assist eligibility. For Family Health Spenddown, set up separate cases for each child whose income causes the family to go to spenddown. For Share, Premium and Rebate, set up one case for the family members who are income ineligible for All Kids/FamilyCare Assist and include all family members in the standard per PM 06-08-02-d.
Determining Eligibility for Child(ren) With Income
For the child(ren) who has income which results in All Kids/FamilyCare Assist ineligibility, spenddown, or an increase in the spenddown, include the parent(s) in the standard. Also include any other children under age 18 in the standard if they live in the home and the parent is responsible for them. Also include unborn children of persons included in the standard.
To determine the child's eligibility, count the total nonexempt income of the parent(s) plus the child's own income. Do not count the income of the other children included in the standard.
Example: Ms. L has 2 children, Dick and Jane, who receive child support. Ms. L has earned income. The family's total income is over 133% of the FPL. In determining Dick's eligibility, use the standard for 3 and count Ms. L and Dick's income only. In determining Jane's eligibility, use the standard for 3 and count Ms. L and Jane's income only.
If more than one child applying for or receiving medical assistance receives child support, divide the $50 income exemption by the number of children. Subtract the prorated amount from each child's income in determining their eligibility.
Determining Eligibility for the Parent(s)
Include eligible children whose income does not affect FamilyCare Assist eligibility in the case with the parent(s).
Include in the standard the parent and the parent's spouse (if in the home), even if the spouse is not applying for medical assistance. Also include all children in the home for whom the parent(s) is responsible. Also include unborn children of any person included in the standard.
To determine the eligibility of the parent(s), count their total nonexempt income. However, do not count the income of the children.