345 Parents and Caretaker Relatives Category

Effective Date: November 1, 2021

Previous Policy

A. General Eligibility Requirements for MAGI- Based PCR and Family Medically Needy

A parent, a relative by blood, adoption or marriage of a dependent child who assumes primary responsibility for the child’s care could be eligible as a parent/caretaker relative if all of the following requirements are met. The section describes the eligibility criteria for the MAGI-based Parent Caretaker Relative (PCR) and Family Medically Needy programs. For Adult Expansion Medicaid see 348 .

1. The individual must be a US citizen or qualified non-citizen ( 205 ).

2. The individual must meet Utah residency requirements ( 207 ).

3. There must be a dependent child in the household ( 345-1 ).

4. The individual must be related to the child ( 345-3 ).

· Take the client's statement on the relationship to the child unless the agency has information that contradicts the client's statement.

5. The child must be deprived of parental support ( 345-2 ).

6. If the only child in the household is an unborn child, and the woman is in her third trimester, see 345-1 for eligibility for both PCR and Family Medically Needy.

7. To establish relationship of the father when the couple is unmarried, see 229-1 .

B. Family Medically Needy

Determine eligibility for Family Medically Needy for households that do not qualify for Parent/Caretaker Relative, 4-Month Extended or 12-Month Transitional. Spenddown is allowed.

1. There must be a dependent child in the household ( 345-1 ).

2. There must be at least one child who meets the deprivation of support criteria for the parent/caretaker relative to be eligible ( 345-2 ).

3. For Medically Needy household size see 404 -1 .

4. The Family Medically Needy program has an asset test. The asset limit is $3,000.00 for two people. Add $25.00 for every additional person.

5. To determine whose income to count for this program, see section 404-5 . To calculate the countable income and the spenddown amount, see section 441-1 .

6. Family Medically Needy households cannot qualify for the 12-Month Transitional or 4-Month Extended.

7. Before closing medically needy coverage, consider on-going eligibility for other medical programs, including Adult Expansion, Child Medicaid or CHIP. Someone who does not qualify for, or does not want, medically needy coverage, may look for a qualified health plan through the Federally Facilitated Marketplace (FFM) and apply for an Advanced Premium Tax Credit (APTC).