405 Caretaker Relative

 

Policy

The conditions of eligibility for the Caretaker Relative program are:

·        Valid application (MA533);

·        Deprived child in the household (MA506);

·        Resident of Arizona (MA531);

·        Social Security number (MA532);

·        US citizen (MA507) or appropriate non-citizen status (MA524);

·        Not incarcerated (MA525);

·        Apply for potential benefits (MA526);

·        Assignment of rights to medical benefits and cooperation (MA503); and

·        Income at or below the limit in MA615.8.

 

The following programs are an extension of Caretaker Relative coverage:

·        Transitional Medical Assistance; and

·        Continuous Coverage.

 

1)    Transitional Medical Assistance (TMA)

Caretaker relatives and the children they live with may become ineligible for Medical Assistance due to excess earned income.  TMA allows these customers to have up to 12 months of additional coverage.

TMA customers can receive six months of TMA eligibility if:

·        At least one member of the household received Medical Assistance as a Caretaker Relative in three of the last six months; and

·        The household is ineligible for Medical Assistance because of earned income.

In addition to the conditions of eligibility listed above, TMA customers can receive an additional six months of TMA eligibility if:

·        The customer whose earned income caused ineligibility continues to work; and

·        The household has income at or below 185% of the FPL.

 

2)    Continued Coverage (CC)

Caretaker relatives and the children they live with may lose eligibility due to an increase in alimony or spousal support payments.  Continued Coverage (CC) allows these customers to have up to four months of additional coverage.

CC customers can receive up to four months of coverage if:

·        At least one member of the household received Medical Assistance as a Caretaker Relative in three of the last six months; and

·        The household is ineligible for Medical Assistance because of increased alimony or spousal support payments.

 

Definitions

Term

Definition

Caretaker  Relative

A Medicaid program for customers who are:

·        An adult relative; and

·        Living and caring for a deprived child.

Transitional Medical Assistance (TMA)

TMA provides transitional coverage for Medicaid customers who become ineligible due to the increased earnings of a caretaker relative.

Continued Coverage (CC)

CC provides coverage for Medicaid customers who become ineligible due to an increase in alimony payments.

 

Service Package

Customers eligible for the Caretaker Relative program receive full AHCCCS Medical Assistance services.  Customers who meet all requirements except U.S. citizenship or qualified non-citizen status receive emergency services only.  See MA302 for details about the AHCCCS Medical Assistance service packages.

 

Enrollment

Customers approved for full coverage under the Caretaker Relative program are enrolled in AHCCCS Complete Care (ACC) plan (Chapter 1100).

Emergency Services are paid for by AHCCCS on a fee-for-service basis.

 

Customer Costs

Customers do not pay a premium for coverage under the Caretaker Relative program.  However, the customer may have co-payments for certain services (MA1205).

 

Legal Authority

This requirement applies to the following programs:

Program

Legal Authorities

Caretaker Relative

Title 42, Chapter 7, Subchapter XIX of the USC

Title 42, Chapter IV, Part 435 of the USC

ARS 36-2901(6)

Title 9, Chapter 22, Article 14 of the AAC