Code of Maryland Regulations
Title 10 - MARYLAND DEPARTMENT OF HEALTH
Part 2
Subtitle 09 - MEDICAL CARE PROGRAMS
Chapter 10.09.24 - Medical Assistance Eligibility
Section 10.09.24.06 - Assistance Unit
Universal Citation: MD Code Reg 10.09.24.06
Current through Register Vol. 51, No. 19, September 20, 2024
A. Purpose and Scope.
(1) This regulation establishes who
shall be a member of an assistance unit, who may be excluded from an assistance
unit, who will have separate eligibility determinations, and whose income and
resources will be considered in determining financial eligibility for
applicants and recipients of Medical Assistance.
(2) This regulation applies to:
(a) Children and their caretaker
relatives;
(b) Persons younger than
21 years old; and
(c) Aged, blind,
or disabled persons.
(3)
This regulation sets forth the requirements for determining eligibility as
aged, blind, or disabled or as families and children.
A-1. More Than One Assistance Unit Among Persons Living Together.
(1) More than one
assistance unit is permissible if:
(a) The
parent or other caretaker relative chooses to have a child's eligibility
determined as blind or disabled under Regulation .04L of this
chapter;
(b) There are unmarried
persons younger than 21 years old not living with an own child, a parent, or
caretaker relative other than parent;
(c) There are unmarried persons younger than
21 years old placed in public or private foster care arrangements;
(d) A caretaker relative chooses to have his
eligibility determined as aged, blind, or disabled under Regulation .04L of
this chapter; and
(e) There are
persons who would have been members of the assistance unit except for their
status as automatically eligible Medical Assistance recipients under Regulation
.03A of this chapter.
(2) Married persons younger than 21 years old
and living with parents or caretaker relatives other than parents are
considered a separate unit from that of the parents or caretaker relatives
other than parents.
A-2. Separate Eligibility Determinations for Certain Persons.
(1) An individual eligibility determination
shall be conducted for each person identified in §§A-1(1)(a)-(c) of
this regulation who requests Medical Assistance.
(2) For the aged, blind, or disabled person
identified in §A-1(1)(d) of this regulation:
(a) If the person chooses to have eligibility
determined as aged, blind, or disabled and either the person's spouse is
non-aged, blind, or disabled or the aged, blind, or disabled spouse chooses to
have eligibility determined as a caretaker relative, an individual eligibility
determination shall be conducted; or
(b) If the person applies as aged, blind, or
disabled and the person's spouse also applies as aged, blind, or disabled, the
couple will be considered one unit.
B. Aged, Blind, or Disabled.
(1) This section is applicable to the
following:
(a) An aged, blind, or disabled
person 21 years old or older who has no unmarried related children younger than
21 years old living with him;
(b)
An aged, blind, or disabled person and spouse, with no unmarried related
children younger than 21 years old living with the couple;
(c) A blind or disabled child younger than 21
years old who chooses to have his eligibility determined as blind or disabled;
and
(d) An aged, blind, or disabled
caretaker relative who chooses to have his eligibility determined as aged,
blind, or disabled.
(2)
Composition-Aged, Blind, or Disabled.
(a) The
assistance unit shall include the following persons, except as provided in
§B(2)(b)-(c) of this regulation:
(i) The
aged, blind, or disabled person; and
(ii) The aged, blind, or disabled spouse of
the aged, blind, or disabled person, when living together.
(b) An aged, blind, or disabled caretaker
relative who chooses to apply as caretaker relative will not be included in the
unit.
(c) A non-aged, blind, or
disabled parent or caretaker relative other than parent will not be included in
the unit.
(3) Income and
Resource Consideration.
(a) In determining
financial eligibility, the income and resources of the following persons shall
be considered:
(i) All persons included in the
assistance unit;
(ii) The spouse of
the applicant, when living together, unless the spouse is an SSI recipient;
and
(iii) The parent of a blind or
disabled child younger than 18 years old, when living together, unless the
parent is an SSI recipient.
(b) Treatment of Income and Resources of
Persons Not Living Together.
(i) When spouses
cease to live together, their income and resources shall be considered
available to each other throughout the month in which they cease living
together. Beginning with the first full month of separate residence, only
actually contributed income and resources from the spouse shall be
counted.
(ii) When a blind or
disabled child younger than 18 years old ceases to live with his parent, the
income and resources of the parent shall be considered available throughout the
month in which they cease living together. Beginning with the first full month
of separate residence, only actually contributed income and resources from the
parents shall be counted.
C. Families and Children-Children Living With Parents or Other Caretaker Relatives.
(1) This
section applies to children, their parents and caretaker relatives other than
parents, and other persons younger than 21 years old. This includes a blind or
disabled child living with a caretaker relative who chooses to have the child's
eligibility determined as a person younger than 21 years old and an aged,
blind, or disabled person who chooses to have his eligibility determined as a
caretaker relative.
(2) Persons
Living Together. The unit shall be established on the basis of persons living
together, including persons who are temporarily absent from the home for
purposes of attending school, or pursuing vocational or job training.
(3) Composition-Children Living With Parents
or Other Caretaker Relatives. The assistance unit shall include, except as
provided in §§A-1 and C(4) of this regulation, the parents, caretaker
relatives other than parents, their unmarried children younger than 21 years
old, and any other unmarried children younger than 21 years old (including
second generation children who are parented by an unmarried person younger than
21 years old) who are related by blood, marriage, or adoption to the parent or
caretaker relative other than parent. The relationship between children and
caretaker relatives other than parents shall be limited to those specified in
Regulation .02B(10)(a) of this chapter.
(4) Exclusion of a Child or Caretaker
Relative Other Than Parent.
(a) The
provisions of §C(3) of this regulation may not apply when:
(i) A parent or caretaker relative other than
a parent chooses to exclude a child from the assistance unit provided at least
one child is in the unit and the exclusion does not cause the applicant or
recipient to lose Medical Assistance (Title XIX) status as a caretaker relative
as defined in Regulation .02B(10)(a) of this chapter.
(ii) A caretaker relative other than a parent
chooses to be excluded from the assistance unit. The choice of exclusion
includes the caretaker relative's spouse.
(b) An excluded aged, blind, or disabled
person retains the option of selecting any federal category in which technical
eligibility may be established upon subsequent application.
(c) An excluded non-aged, blind, or disabled
person may not have a separate eligibility determination.
(5) Subsequent Application for an Excluded
Person.
(a) A person excluded from the
assistance unit may apply for Medical Assistance.
(b) If an excluded person applies as aged,
blind, or disabled, the following conditions apply:
(i) A separate eligibility determination will
be made in accordance with §A-1 of this regulation; and
(ii) Income and resources of a spouse or
parent will be considered in accordance with §B(3) of this
regulation.
(c) If an
excluded person does not apply as aged, blind, or disabled, the following
conditions apply:
(i) The period under
consideration will be the same as that of the currently eligible assistance
unit;
(ii) Eligibility for the new
member shall be determined in conjunction with the currently eligible
assistance unit established in §C(3) of this regulation;
(iii) The income and resources of the new
member shall be added to that of the currently eligible assistance unit
beginning with the month for which coverage of the new member is
requested;
(iv) The income of the
new member may not be averaged to include any months before the month for which
coverage is requested;
(v)
Certification may not begin earlier than the date the new member becomes
eligible; and
(vi) A decision of
ineligibility for the new member will not affect the eligibility status of the
currently eligible assistance unit for the remainder of the certification
period.
(6)
Income and Resource Consideration-Families and Children.
(a) In determining financial eligibility, the
income and resources of the following persons shall be considered:
(i) All persons included in the assistance
unit;
(ii) The spouse of the
applicant, when living together, unless the spouse is an SSI recipient;
and
(iii) The parent of a child
younger than 21 years old, when living together, unless the parent is an SSI
recipient.
(b) Treatment
of Income and Resources When a Child Leaves the Home. The income and resources
of a parent shall be considered throughout the month in which a child leaves
the home for the purpose of establishing a new address, when the separation is
for reasons other than placement in a foster home, group home, or drug or
alcohol abuse treatment center. Beginning with the first full month of separate
residence, only actually contributed income and resources from the parent shall
be counted.
D. Additions to the Household. A new member of the household will be considered in accordance with all applicable regulations of this chapter.
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