A family that is receiving TANF or Family Assist may be able to keep receiving medical benefits under Medical Extension (ME) when their income exceeds the income standard.
To receive ME, 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; or
- spousal support.
If a family lost eligibility for some other reason, they do not qualify for ME.
The person who is working, or who receives the spousal support, has to be a parent or caretaker relative in the TANF 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 ME 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 timely.
Example 1: Steve and his 6 year old son, Pete, are active on a Family Assist and All Kids Assist case. Steve receives a raise from his employer on 05/09/2022. Income verification is received on 07/08/2022. The household income is above the Family Assist standard. The household is eligible for ME. May 2022 is the first month Steve received the increase in income and is determined to be the first month of the ME period.
Medical Extension due to Earnings
A family can receive ME for up to 12 months. An eligible family receives an initial 6 months of ME and can then receive an additional 6 months if they meet the criteria listed in PM 18-05-07.
Customers must provide verification of an increase in earned income by cutoff of the fourth month from the month in which the increase was received or the customer will not be eligible for ME.
Example 2: Dawn and her 10 year old son, David, are active on a Family Assist and All Kids Assist case. Dawn is unemployed and was hired for a new job that started 03/05/2022. Dawn receives her first pay from the new job on 03/19/2022. Verification of the earned income must be received by 6/15/2022. Customer provides verification on 05/31/2022. The new income is above the Family Assist standard. Since the increase was due to earnings, customer is eligible for ME beginning 03/2022.
Medical Extension due to Spousal Support
Spousal 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.
Adults in the family can receive ME for up to 4 months. Persons under age 19 remain eligible under Continuous Eligibility. Verification of an increase in spousal support must be received prior to cutoff of the third month after the increase or the customer will not be eligible for medical extension.
Example 3: Mary and her 10 year old daughter, Jill, are active on a Family Assist and All Kids Assist case. Mary receives an increase in spousal support on 04/11/2021 that puts the household income over the Family Assist standard. Mary reported the increase on 06/25/2021. The household is not eligible for medical extension due to the late reporting of the increase in spousal support. Mary needed to report the increase before cutoff of May (third month after the increase was received) to be eligible for medical extension benefits.
Note: IES is programmed to generate a REDE notice before adults reach the 4 month limit.
Medical Extension is Only Displayed in IES for Ongoing Months
The type of assistance displayed on the Eligibility Summary page will be All Kids Assist (AK Assist) and Family Assist (Family Care) for months prior to the approval of ME. The ongoing months will display the type of assistance as ME (Med Ext) for adults and continue to display All Kids Assist for the children.
Example 4: Sandra and her 11 year old daughter, Madison, are active on a Family Assist and All Kids Assist case. Sandra receives an increase in her employment income on 02/02/2022. The increase in income is above the Family Assist standard. Sandra provides verification of the increase on 04/17/2022 and is approved for the ME. Sandra and Madison will show as active in Family Assist and All Kids Assist through 05/2022. Beginning 06/2022, the Eligibility Summary page will display the type of assistance as "Med Ext" (Medical Extension) for adults and continue to display All Kids Assist for the children.