Page 148

148 (07/2026) Chapter 2:Eligibility • Section 2: Eligibility groups The filing group consists of people from the household group who: • Choose to apply for benefits, and • Meet non-financial eligibility requirements, and • Must apply for benefits because of their relationship to those people. If the filing group does not include at least one applicant who meets all non-financial eligibility requirements, the group is ineligible. In the REF and REFM programs, the filing group consists of an adult applicant and the following members of the household group: • The spouse of the applicant. • Each dependent child of the adult in the filing group. Individuals receiving TANF cannot be in a REF filing group. Unlike TANF, an unborn child does not connect two single adults together in a filing group. When a REF filing group contains a single pregnant female, remember to revisit eligibility for TANF once the pregnancy has reached the month before the due date, or in cases involving TA-DVS. If the woman is receiving REFM, remember to have them revisit Medicaid eligibility as soon as you become aware of the pregnancy. If they are determined ineligible for Medicaid, they may continue to receive REFM until the end of their eligibility period. MSP The filing group is the people from the household group whose circumstances are considered in the eligibility determination process. A person’s circumstances must be considered either because they request assistance or because of their relationship to household members who request assistance. You cannot add people at this point (or at any other). If an individual isn’t in the household group, they will never be in the filing group. The filing group consists of each applicant and the following household group members: • The spouse of each applicant. Remember that if a couple is separated (legally or otherwise) and living apart, the spouse would not be in the filing group because they are not in the household group. On the other hand, if they are separated (legally or emotionally) but still cohabitating, then the spouse is in the filing group. Again, applying for or receiving services has no effect on Medicare Savings Program eligibility groups whatsoever, it’s all about who lives with whom. • Each parent of each child, if the children are applying and are not assumed eligible. • Children of the applicant if the applicant wants to include these children in the filing group. The applicant can choose to include one child and not another based on the income of each child (i.e. applicant can pick and choose amongst children). Note: Applicants would want to include a child if the child had no or little income and the parent was over the income standard without them. OSIPM The filing group is the people from the household group whose circumstances are considered in the eligibility determination process. A person’s circumstances must be considered either because they