PM 18-05-05
Determination for Medical Extension
When the worker reruns eligibility and the family is financially ineligible for TANF, or a parent or caretaker relative who received FamilyCare has income that increases above the Family Assist standard (when it was previously at or below the Family Assist standard), the system will determine if the family qualifies for Medical Extension (ME) per PM 18-05-06.
Families that Don't Qualify for Medical Extension
If the family is not eligible for ME:
- For children under age 19, the child receives All Kids Assist for the remainder of the 12 month certification period.
- For adults aged 19 and over, IES will determine eligibility for other medical programs. Medical benefits are canceled if income exceeds the FamilyCare Assist Standard and the adult does not qualify for another program.
Example 1: Ms. Zee received TANF and medical benefits with her 2 children since December 2016. On 06/07/17, Ms. Zee reports that she has a new job. Due to her increased earned income she no longer qualifies for TANF. When her income is entered into Data Collection and her eligibility is rerun, the system determines that the family qualifies for ME.
Example 2: Ms. Aye receives FamilyCare and All Kids Assist with her 2 children. Countable monthly income is $1,800. The last month of their certification period is 06/2017. On 01/07/17, Ms. Aye reports that she has a new job and countable income is now $6,500, which is above the All Kids Assist, and the FamilyCare Assist Standard for a household size of 3. The updated income is entered into IES.
The family does not qualify for ME because income was not at or below the Family Assist level for 3 of the last 6 months. Since the current certification period is not ending, the children continue to receive All Kids Assist until the end of the certification period. Medical benefits are canceled for Ms. Aye and she is referred to the Marketplace.
Example 3: Mr. Bee and his child receives FamilyCare and All Kids Assist. Countable income is $1,200. The last month of their certification period is 06/2017. On 06/01/17 in response to the REDE, Mr. Bee reports that he has a new job and countable income is now $5,200, which is above the Assist standard for a household size of 2.
The family does not qualify for ME because income was not at or below the Family Assist level for 3 of the last 6 months. Since the certification period is ending, when the REDE is certified in IES with the updated income amount, medical benefits are canceled and the family is referred to the Marketplace.
