Utah Admin. Code R414-303-5 - Medicaid for Parents and Caretaker Relatives, Pregnant Women, and Children Under Non-MAGI-Based Community and Institutional Coverage Groups

(1) The Department provides Medicaid coverage to individuals who are eligible as described in 42 CFR 435.117, 435.139, 435.170 and 435.301 through 435.310, October 1, 2012 ed. and Title XIX of the Social Security Act Sections 1902(e)(1), (4), (5), (6), (7) in effect January 1, 2013, which are adopted and incorporated by reference.
(2) To qualify for coverage as a medically needy parent or other caretaker relative, the parent or caretaker relative must have a dependent child living with the parent or other caretaker relative.
(a) The parent or other caretaker relative must be determined ineligible for the MAGI-based Parent and Caretaker Relative coverage group.
(b) The parent or other caretaker relative must not have resources in excess of the medically needy resource limit defined in Section R414-305-5.
(3) The income and resources of the non-parent caretaker relative are not counted to determine medically needy eligibility for the dependent child.
(4) To qualify for Child Medically Needy coverage, the dependent child does not have to be deprived of support and does not have to live with a parent or other caretaker relative.
(5) If a child receiving SSI elects to receive Medically-Needy Child Medicaid, the child's SSI income shall be counted with other household income.
(6) The eligibility agency shall determine the countable income of the non-parent caretaker relative and spouse in accordance with Section R414-304-6 and Section R414-304-8.
(a) Countable earned and unearned income of the non-parent caretaker relative and spouse is divided by the number of family members living in the household.
(b) The eligibility agency counts the income attributed to the caretaker relative, and the spouse if the spouse is included in the coverage, to determine eligibility.
(c) The eligibility agency does not count other family members in the non-parent caretaker relative's household to determine the applicable income limit.
(d) The household size includes the caretaker relative and the spouse if the spouse also wants medical coverage.
(7) An American Indian child in a boarding school and a child in a school for the deaf and blind are considered temporarily absent from the household.
(8) An individual who is pregnant, and under 19 years of age as described in Subsection R414-302-3(2), may only receive coverage through the end of the month in which the individual turns 19 years old.


Utah Admin. Code R414-303-5
Amended by Utah State Bulletin Number 2016-14, effective 7/1/2016

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