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If the last dependent child ages out or leaves the home, or if the last adult changes categories or leaves the home, TMA will be removed, and other eligibility will be explored for all household members. TMA eligibility for a family follows the parent/caretaker whose earnings initially increased, and any other member who moves out loses TMA. iii

A second parent who enters the household after the TMA period has been established may also qualify for TMA, and their income will be counted for the TMA household. Dependent children who enter the household after the TMA period has been established and would be mandatory TANF members also qualify for TMA. All members added after TMA has already begun will join for what time remains in the existing TMA period and will not receive a new/full 12 months of their own.iv A member joining the case late in the TMA period will not be added to a TMA household which already has had the redetermination process begin but will be processed for normal HIP coverage.

3810.00.00 TMA CATEGORY CHANGE & EFFECTIVE DATE

TMA goes into effect on the date when the parent/caretaker would first have been without coverage due to financial failure.

3810.05.00 MEMBERS WHO WOULD HAVE FORMED TMA UNDER PRIOR RULES

Low-Income Parent/Caretakers are guaranteed HIP State Plan benefits only so long as they qualify under that designation. Adults whose income increases above the low-income standard but does not increase to over 133% FPL (plus MAGI disregard) will no longer be placed in TMA. These members will move out of HIP State Plan into HIP Regular Plan unless they are also Medically Frail.

To retain vision and dental benefits, members in HIP Basic coverage will be required to begin or continue paying POWER Account payments in HIP Plus.

Any adult in Basic coverage when Low-Income Parent/Caretaker status is lost will be given a Potential Plus opportunity with 60 days to make their first PAC payment and transition to Plus. If the member does not pay the PAC, then normal no-pay processes will be applied, and HIP will be closed unless income is at or under 100% FPL.

3810.10.00 MA F FOR CHILDREN AND TMA BUDGETING

Minor dependents switching to TMA coverage will all be placed into the “MA F” category. MA F should never have any adult payees, who instead will show as non-participating adults. If any child is not receiving minimal essential coverage (MEC), TMA will not form for the family. At least one child must be receiving Medicaid for TMA to form.

MA F may show some or all children listed as non-participating if they are not receiving Medicaid due to other minimally essential coverage (MEC), for instance if a non-custodial parent is