Budgeting Procedures for Continuous Eligibility for Children Under Age 19 510-05-90-75

(Revised 10/5/2023 ML #3766)

View Archives

When a child becomes continuously eligible for Medicaid, that child continues to be eligible without regard to any changes in income and/or expenses of the Medicaid unit until the next review. Likewise, a continuously eligible child can move from one coverage category to another (e.g. Foster Care to Poverty Level); however, if PL eligible and income increases to above PL, the child remains PL eligible until the end of their continuous eligibility period.

For a continuously eligible child residing in a nursing facility, the state hospital, a Psychiatric Residential Treatment Facility (PRTF), or receiving swing bed care in a hospital: the recipient is allowed the $100 nursing care income level and excess income becomes client share (recipient liability).

Recipients residing in an intermediate care facility for the intellectually disabled (ICF-ID) (including the Anne Carlsen facility): The recipient is allowed the $135 ICF-ID income level.

For a single individual under age 19, parental income is not considered available during any full calendar month the recipient is in the facility.

If the individual has no source of income, and is ineligible for SSI, the income of the parents may be deemed in the amount of $100, (or $135, if the individuals is in an ICF-ID) to meet the maintenance needs of the individual.

NOTE: The premium calculation for Children/Workers with Disabilities is still required.