New York Codes, Rules and Regulations
Title 18 - DEPARTMENT OF SOCIAL SERVICES
Chapter II - Regulations of the Department of Social Services
Subchapter B - Public Assistance
Article 2 - Determination of Eligibility-Categorical
Part 360 - MEDICAL ASSISTANCE
Subpart 360-4 - Financial Eligibility
Section 360-4.2 - Size of MA household

Universal Citation: 18 NY Comp Codes Rules and Regs § 360-4.2

Current through Register Vol. 46, No. 39, September 25, 2024

(a) For needy individuals under 21, pregnant women, persons ineligible for ADC solely because their incomes and resources exceed ADC eligibility standards, and parents described in section 360-3.3(b) of this Part, an MA household is all MA applicant(s)/recipient(s) who live together in a single dwelling who apply for or receive MA as a unit, and any legally responsible relative who does not receive HR. ADC, or SSI and resides with an applicant/recipient. Any person who receives HR, ADC, or SSI will not be included as a member of an MA household, and the income and resources of such a person will not be considered when social services districts determine the MA eligibility of the applicant(s)/recipient(s).

(b) For adults who are aged, certified blind or certified disabled, an MA household is the aged, blind or disabled person and his or her spouse who lives with him or her if the spouse is:

(1) also aged, certified blind or certified disabled, or

(2) has remaining income after allocation which is equal to or greater than the difference between the medically needy income standard for one, and the medically needy income standard for two. For other aged, certified blind or certified disabled adults who live with their spouses, an MA household consists of one person for income purposes, but consists of two persons for resource purposes. For all other aged, certified disabled, or certified blind applicant(s)/recipient(s), an MA household consists of one person.

(1) An MA household which contains a pregnant woman will be increased by one if the pregnancy is medically verified, except for applicant(s)/recipient(s) whose eligibility is being determined under the budgeting methodology used for aged, certified blind and certified disabled individuals. The increase will begin three months prior to the month of application or on the date of conception, whichever is later.

(2) A household member who is temporarily absent, as defined in section 360- 1.4(p) of this Part, will continue to be included in the household.

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