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.
Notes
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