29.03 Formation of the financial responsibility group

In general. The financial responsibility group for MABD consists of the individuals whose income and resources are considered available to the Medicaid group in the eligibility determination. With some exceptions, spouses are considered financially responsible for each other, and parents are considered financially responsible for their children. The following paragraphs set forth the rules for determining membership in the financial responsibility group and the portion of the group’s income considered available to the Medicaid group. Financial responsibility group for an adult. The financial responsibility group for an adult requesting MABD, including Medicaid coverage of long-term care services and supports under MABD, is the same as the adult’s Medicaid group. Financial Methodologies Part 5 – Page 11 (Sec.29.00, Sub.29.03) Financial responsibility group for a child. The financial responsibility group for a child requesting MABD includes the child and any parents living with the child until the child reaches the age of 18. Financial responsibility group for a sponsored noncitizen The financial responsibility group for a noncitizen admitted to the United States on or after August 22, 1996, based on a sponsorship under §204 of the INA, includes the income and resources of the sponsor and the sponsor’s spouse, if living with the sponsor, when all four of the conditions set forth in (i) through (iv) below are met. Children and pregnant women who are exempt from the five-year bar pursuant to § 17.03(c)(6) are not subject to these provisions. The four conditions are as follows: (i) The sponsor has signed an affidavit of support on a form developed by the United States Attorney General as required by the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA) to conform to the requirements of §213A(b) of the INA; (ii) The noncitizen is lawfully admitted for permanent residence, and a five-year period of ineligibility for MABD following entry to the United States has ended; (iii) The noncitizen is not battered; and (iv) The noncitizen is not indigent, defined as unable to obtain food and shelter without assistance, because their sponsor is not providing adequate support. The financial responsibility of a sponsor continues until the noncitizen is naturalized or credited with 40 qualifying quarters of coverage by the SSA (see (3) below for crediting of qualifying quarters). A non-citizen is credited with the following qualifying quarters of coverage as defined under Title II of the Act: (i) Those worked by the non-citizen; (ii) Those worked by a parent of such non-citizen while the non-citizen was under age 18 unless the parent received any federal means-tested public benefit during the period for which the qualifying quarter of coverage is credited after December 31, 1996; (iii) Those worked by a spouse of the non-citizen while they were spouses, as long as the non-citizen remains the spouse or the spouse is deceased and the spouse did not receive any federal means- tested public benefit during the period for which the qualifying quarter of cover is credited after December 31, 1996; (iv) For this purpose, federal means-tested benefits do not include: Emergency medical assistance; Short-term, non-cash, in-kind emergency disaster relief; Assistance under the National School Lunch Act or the Child Nutrition Act of 1966; Public health assistance for immunizations or testing and treatment of symptoms of communicable diseases not paid by Medicaid; Financial Methodologies Part 5 – Page 12 (Sec.29.00, Sub.29.04) Payments for foster care and adoption assistance under parts B and E of Title IV of the Act, under certain conditions; Programs, services or assistance specified by the Attorney General; Programs for student assistance under Titles IV, V, IX, and X of the Higher Education Act of 1965, and Titles III, VII, and VIII of the Public Health Service Act; Means-tested programs under the Elementary and Secondary Education Act of 1965; Benefits under the Head Start Act; or Benefits under the WIA.