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UPDATED: AUGUST 1999

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OTHER ELIGIBILITY REQUIREMENTS LIVING ARRANGEMENTS

LIVING IN OWN HOME

Description: An A/R is living in his/her own home when s/he is living alone, living with friends or relatives, living in a congregate care situation or living in foster care. Policy: Medicaid may be given to an otherwise eligible person living in his/her own home.

References: SSL Sect.

365 366 371 374

Dept. Reg.

360-6.6(a)

ADMs

92 ADM-15 90 ADM-18

LCMs

93 LCM-89

Interpretation: For Medicaid purposes, "home" indicates a type of residence where Medicaid may be received. The term commonly used is "community based".

An A/R may live with friends and/or legally responsible relatives and be eligible for Medicaid "in his/her own home". When an applicant is living in a communal situation, the arrangement should be investigated. When the communal arrangement represents itself as an organization, whether religious or fraternal, the status of the organization is determined. If the applicant made a commitment to the organization in return for the organization agreeing to meet his/her needs, a determination is made as to whether or not this includes medical needs. In such an agreement, resources may be held in common.

An individual is living in his/her own home when s/he is living in a congregate care situation. Some examples of congregate situations are foster care for children and adult care facilities such as family type homes for adults, shelters for adults and residences for adults. These adult care facilities provide shelter for adults who, though not requiring continual medical or nursing care, are, by reason of physical or mental disability associated with age or other factors, unable to live independently. (MRG)