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Families and Children Manual Section: Financial Eligibility Policy Manual Number: 010.040 Chapter: Medically Needy Eligibility Determination Group

a. The applicant; b. The applicant’s unborn child(ren); c. The applicant’s children under 21; and d. The applicant’s spouse (if under 21 and applying for medical assistance).

If the in-home spouse is not included in the EDG, the spouse’s income and resources may be deemed to the applicant.

5. Financially Responsible Relative (FRR) Principle

The income and resources of a parent or spouse, FRR, living in the applicant’s household are considered available to the applicant. Income and resources of relatives other than a parent or spouse are not considered available to the applicant. Income and resources are not considered available when an FRR receives Families First, Supplemental Security Income (SSI) or needs-based Veterans Affairs (VA) Benefits.

a. Income and Resources of a Parent

The income and resources of the parents of a child under age 21 are considered available to the child in determining her financial eligibility when:

i. The child and parent(s) live together; ii. The child is unmarried; and iii. During the child’s temporary absence from the home.

Note: The 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 her FRR.

b. Joint Custody/Parenting Time

For the purpose of determining Medicaid eligibility, the custodial parent, often referred to as the primary residential parent in Tennessee, is established based on physical custody specified in a court order, binding separation, divorce, or parenting plan. If there is no court order or parenting plan, custody of a child born out of wedlock is with the mother. If there is a parenting plan, the primary residential parent is the parent with whom the child spends most nights.

i. Equally-Shared Joint Custody/Parenting Time

When an individual claims that equally-shared (50/50) joint physical and legal custody exists or provides a parenting plan that evenly divides the child(ren)’s living arrangement and parenting responsibilities, the parenting time situation must be carefully examined. Though a court order or parenting plan may evenly divide the care and control of the child(ren), the parents may not, in fact, be following the parenting plan.

In cases of alleged equal parenting time (50/50): March 18, 2019 Division of TennCare 2