28.04 Medically-needy MCA – income eligibility

In general. Income eligibility of an individual requesting medically-needy MCA is determined by calculating the individual’s MAGI-based income as described in § 28.03(d). The individual’s MAGI-based income is then adjusted, if applicable, by apportioning the income of financially responsible family members according to the requirements set forth in paragraph (b) of this subsection. 15 42 CFR § 435.603(j). 16 42 CFR § 435.603(k). Financial Methodologies Part 5 – Page 8 (Sec.28.00, Sub.28.05) For the individuals who may qualify for medically-needy MCA, see § 7.03(a)(8). Financial responsibility of relatives and other individuals17 Financial responsibility of relatives and other persons for the individual is limited to the following: (i) A spouse for their spouse when both are living in the same household; and (ii) A parent, step-parent, or adoptive parent for their unmarried child under the age of 21 living in the same household unless the child is pregnant or a parent whose own child is living in the household and they make a monthly (or more frequent) room or board payment to their parents. Except for a spouse of an individual or a parent for a child who is under age 21, no income or resources of any other relative will be considered as available to the individual. When a couple ceases to live together, only the income of the individual spouse will be counted in determining their eligibility, beginning the first month following the month the couple ceases to live together. Spenddown. The income spenddown provisions set forth in § 30.00 apply to an individual requesting medically-needy MCA. For purposes of the spenddown provisions at § 30.00, anyone identified in paragraph (b) above as financially responsible for the individual is considered a member of the individual’s financial responsibility group as that term is used throughout § 30.00.