Medicaid Eligibility and Stepparent Income

[findmeinflorida]

2 children out of wedlock 10 yrs ago. 1 child with my husband. Father of first 2 is in jail in another state, has been 3 years now. No support period. I have sole custody, step-dad has raised them in all ways. I stay home to care for the younger child, and do not have any income.We have had them insured on step-dads insurance always. He has a new job, and new insurance. New insurance does not want to cover step-kids(my first 2). So I apply for Medicaid for them only. Medicaid says they need step dads income info. Handbook I read said step-parent income is not used, parents only is. I write a letter to Medicaid case worker. She sates that because we have child #3 together that there is a biological connect in the house, and his income is required. He forbids me to share it as it is against his religious background and values to deal with the system. Im sure he is over the limit anyway. My dilemma is that I can't get them insurance either direction. We all have it, but not my first 2. I have requested an appeal. What can I say or do to get them covered?

[Dogmatique]

Out of interest, which religion prevents step-dad from releasing such information?

Why doesn't your husband's insurance cover stepchildren? (ie, what reason did they give?)

That aside, talk to the case worker again. Ask her to provide the rule or statute which allows a stepparent's income to be used.

[findmeinflorida]

Raised Omish, but left. His insurance is practically unheard of, and asked for the order stating who is responsible for health care. It states 50/50 between myself and absent father. I am unemployed, and absent father is incarcerated. They say responsibility is between the parents as is in the order. Just got the paperwork and hearing date. They state: 230.0405.02 Stepsiblings may be included, or other children in the home who meet all 1931 medicaid elig. criteria may be included in the SFU.--2230.0404.08 when a parent and step-parent are in the home, the parents needs are included in the group with the child. Step-parents who have no elig. children of their own may not be included in the AG---- states" his income should be deem to mother? correct---states" Income of a step-parent whose needs are not included in the assistance group and who is living in the homers. e is still considered part of the family group and is considered available as unearned income to the TCA child unless the s-parent is on ssi, oss, or icp recipient. income exclusions in chapter 2400 apply. states' we will need his income to be deemed to the mother is unable to determine eligibility.... 1830.0117, 2230.0404.06, 2230.0404.08, 2230.0405.01, 2230.0405.02, 2230.0405.04 are all starred in the papers. Only leg I think I have is that in the main handbook it states that the stepparents income DOES NOT count. It does not say MAY NOT count. Then when they send all the fine print you see it stated over and over in each section "MAY BE included". I did find in the medicaid changes that are supposed to come into affect in 2014, that it will be by the custodial or primary parents household. any thoughts on what to have prepared for the hearing? thanks

[Mr. Knowitall]

Saying "His insurance is practically unheard of" is not a helpful answer to the inquiry, "Why doesn't your husband's insurance cover stepchildren? (ie, what reason did they give?)" Dogmatique is trying to figure out if the insurance company can be compelled to provide coverage.

The claim of a religious objection to disclosing their income in association with an application for needs-based public assistance is not sufficient to overcome the state's requirement that the information be provided.

The issue here is that you're asking for yourself and your separate children to be classified as a separate SFU and, while your spouse's income won't be deemed to his stepchildren, you are part of the SFU and thus it must be considered in relation to you.

Some of the regulations at issue:

...The Standard Filing Unit (SFU) is the single individual or group of individuals whose income, assets, or needs are considered in the eligibility determination and benefit, income, and asset levels of the assistance group, because they share a legal or blood relationship and/or live together. Eligibility of the assistance group is based on a review of the total income and assets of all individuals in the SFU.

All minor siblings (including half-brothers and half-sisters) living with the child for whom assistance is requested or if away from home, meeting the conditions of temporary absence, must have their needs included, provided the sibling meets all 1931 Medicaid eligibility criteria.

Minor siblings are those brothers and sisters under the age of 18 who have never been married or whose marriage was annulled. The needs of these children must be included through the month of their 18th birthday, unless born on the first day of the month. If born on the first day of the month, their needs must be removed effective the birth month.

If the two-parent family with at least one mutual child is ineligible for payment standard related Medicaid benefits as one SFU, Medicaid assistance under payment standard related Medicaid coverage may be accessed for the nonmutual child and their parent. The income of the stepparent must be deemed in determining the Medicaid eligibility of the parent of the nonmutual child under this coverage group. Income of the stepparent is not deemed to the child.

When there are two legally married stepparents in the home and neither is an SSI, OSS, or ICP recipient and each has children who are eligible for 1931 Medicaid (nonmutual children), two standard filing units (SFU’s) must be set up.

If there is a mutual child and one or both parents are incapacitated or one parent is an unemployed principal earner or an SSI, OSS, or ICP recipient, one SFU must be set up. The children’s needs and the needs of the incapacitated or PE parent(s) must be included in the SFU.

When a parent and a stepparent are in the home, the parent's needs are included in the assistance group with the child. Stepparents who have no eligible children of their own may not be included in the AG under any circumstance.

Any stepbrothers, stepsisters, or other children in the home who meet all 1931 Medicaid eligibility criteria may be included in the SFU.

[CourtClerk]

You could just go get a job and buy an individual policy for your 2 children if he doesn't want to provide his income information.