Page 3

Health Care Finance and Administration Policy Manual Number: 110.020 Section: Financial Eligibility Requirements Chapter: ABD Financially Responsible Relatives July 1, 2016 HCFA 3 b. Determining Marital Relationship Accept the individual’s attestation regarding marital status if he or she is married, unmarried or separated from his or her spouse. c. Holding Out Spouse A “holding out” relationship exists when an unrelated man and woman present themselves to the community as husband and wife in the absence of a legal marriage. The concept of a holding out relationship does not apply to the MSPs or Institutional Medicaid categories. 4. Parental Financial Responsibility a. When Parental Financial Responsibility Applies The income and resources of the parents of the child are considered available to the child in determining his or her financial eligibility: • When the child and parent(s) live together; and • During the child’s temporary absence from the home. A child’s admission to a psychiatric facility is considered a temporary absence. Psychiatric care is not considered institutionalization for purposes of determining the under age 21 individual’s separation from his or her FRR. b. When Parental Financial Responsibility Does Not Apply The income and resources of the parents of the child are not considered available to the child in determining his or her financial eligibility when the child applies for Long-Term Supports and Services, unless a child under 18 is determined eligible at an “At Risk” for nursing facility Level of Care and is requesting HCBS services in the Employment and Communities First (ECF) program. c. Step-parents The income and resources of a step-parent living in the home are considered available to the child when the step-parent is the spouse of the child’s natural or adopted parent and the natural or adopted parent is living in the home with the child.