Appendix B: Category Structure—Examples

The following examples show the category to be assigned in both NMP and MNO cases. In each example, the applicants have given all needed proof. The CAO must determine eligibility first for NMP and then for MNO. The CAO must always provide MA under the program that best meets the individual’s medical needs.

1. Unrelated Individuals

Mary F., age 40, applies for MA for herself and Joyce N., age 10. Joyce's mother is a close friend of Mary's and granted legal custody of Joyce to Mary. Because Mary has legal custody of Joyce, she is considered a custodial caretaker.

2. Married Couple/Pregnant Woman

Mr. P. and his wife, both age 22, apply for MA. Mrs. P. is pregnant and works at a job for 20 hours a week. Mr. P. is expected to be temporarily disabled through the due date of the baby.

3. Under Age 21

Mr. M., age 19, applies for MA.

4. Healthy Beginnings/TANF Related

Mr. W., age 28, applies for MA for himself, his wife, and their children, Steve, age 9, Martha, age 5, and Naomi, age 2. Neither Mr. W. nor Mrs. W. is incapacitated.

5. Healthy Beginnings/NMP or MNO

Mrs. B. and her two children, Maureen, age 3, and Carol, age 5, apply for MA. Mrs. B. gets spousal support and child support for each of the children.

NOTE:  The children getting Healthy Beginnings are not legally responsible relatives (LRR) to Mrs. B. The CAO must not include the children or their income when determining NMP or MNO unless doing so will benefit Mrs. B.

6. Unemployed Pregnant Woman

Mr. and Mrs. H., both age 25, apply for MA. Mrs. H. is pregnant with their first child. Mr. H. gets partial UC and is employed 15 hours a week.

7. GA-Related

Mr. D., age 64, applies for MA and meets one of the GA criteria. He has applied for Social Security Retirement benefits.

8. Healthy Horizons—Presumptive Eligibility

Mr. Y., age 63, applies for MA. He suffered a stroke six months ago, which left him forced to stay in bed. The Social Security benefits he gets are retirement benefits. He retired 11 months ago.

9. TANF-Related Deprived Child

Mrs. F., age 46, applies for MA for herself and her daughter, Pat, age 18. Pat is a 12th-grade student who is expected to graduate before she is age 19. Mrs. F. is divorced from Pat's father and gets no support for Pat.

10. Healthy Horizons/TANF Child

Mr. D., age 65, applies for MA for himself, his wife, age 43, and their children, Ron, age 15, Stan, age 13, and Roz, age 10. Mr. D. retired three years ago and gets Social Security retirement benefits. Mrs. D. has never worked outside of the home. Neither parent claims to have any health problems.

11. Unmarried Couple With Child

Ms. H., age 19, applies for MA for herself, her 10 month-old daughter, Violet, and her boyfriend, Mark J., age 21. Mark states that he is Violet's father, but paternity has not been legally proven. Mark would have to be opened in a separate case record, if he is eligible for GA-related MA, until paternity is established.

12. Married Couple/Disabled Child

Mr. E., age 40, applies for MA for himself, his wife, age 39, and their children Sam, age 10, and Diane, age 9. Sam got SSI but lost his benefits eight months ago because of Mr. E.'s income from employment. His condition has not improved since his SSI stopped. Mr. E. was laid off two months ago and is getting UC.

NOTE:  If Sam is at any point found eligible for an SSI payment, then he will become a J and will not be included in the NMP for the Family computation.

Reminder: An individual who is eligible for SSI-related MA/Healthy Horizons must be included in the NMP when family income is counted.

13. Married Couple with Stepchildren

Mr. G., age 46, applies for MA for himself, his wife, age 40, and his two stepdaughters (her daughters), ages 15 and 10. The family's only income is support from the children's father. The family was reviewed for and did not meet the requirements for NMP for the Family.

14. Elderly Spouse

Mr. S., age 66, applies for MA for himself and his 64 year-old wife. Mr. S. is blind. Mrs. S. has health problems and meets the requirements for GA.

Updated February 14, 2012, Replacing January 29, 2010