Page 11

10

Some assistance groups may include members who have multiple addresses, such as children in school or under joint physical custody.

The primary residence is the location where the individual spends the majority of time during the month.

An individual who spends the majority of his/her time away from the residence of the assistance group but who has no consistent alternative location due to employment which requires frequent travel, is considered a member of the assistance group. However, if the individual establishes a residence away from the assistance group, then he/she would not be considered as a member. This also applies to students who live away at school and only return home on weekends.

When the entire assistance group has multiple residences, the primary residence is determined in the manner described above.

3210.00.00 MEDICAID ASSISTANCE GROUPS (MED 1)

The MED 1 categories of assistance are not subject to MAGI methodology for the determination of income and household size (AG). For the MED 1 categories, there is one participating AG member. Nonparticipating members are those individuals whose income, resources, and/or expenses must be considered in the eligibility determination and/or in the post-eligibility calculation.

3210.05.00 NON-INSTITUTIONALIZED APPLICANT/RECIPIENT (MED 1)

The policy contained in this section only applies to the MA A, MA B, and MA D categories of assistance.

When the applicant/recipient (participating member) is in a living arrangement other than a Medicaid certified long-term care facility, the AG consists of the applicant/recipient and the nonparticipating members listed below:

• The spouse of the applicant/recipient if the couple is living together or separated only for medical reasons. • A spouse receiving HCBS Waiver services will be excluded from non-waiver spouse applicant/recipient. • The biological or adoptive parent(s) of a child applicant/recipient who resides with the parent(s) and who does not qualify for certain Home and Community Based Services (HCBS) waivers as specified in Section 3220.15.00. • The biological, adoptive, or stepchild of the applicant/recipient who is living in the same home. • A child who is a sibling of the child applicant/recipient who lives with the applicant/recipient and his biological or adoptive parent.