Example 3: Disabled Dad, Mom & three children

The family consists of a disabled Dad who receives $1,200 SSA Disability/month, Mom who is unemployed and three children, ages 14, 6 and 3. Each of the children receives $275 SSA due to Dad’s disability. We’d first test all family members for grant eligibility, but Dad’s grant budget allocates his income over to the ADC grant budget. The ADC grant budget fails due to both the allocated income and the children’s SSA, so all five family members are then evaluated for Medicaid eligibility.

The net income for the family is $1,200 (Dad’s SSA) - $20 general AABD disregard = $1,180 + $825 (Children’s SSA) = $2,005. This income is under 200% FPL for five so the three children would qualify for CHIP if they are uninsured.

To determine Dad’s eligibility at 100% FPL for five, we’d only use Dad’s net SSA of $1,180. Dad is therefore eligible as AABD/OMB.

Note: A child’s income is never counted in a disabled parent’s budget.

If the children are covered by creditable health insurance, the 3-year-old still passes 133% FPL for five. Because the 3-year-old has passed at her income level, we do not use this child’s $275 SSA when we are testing the two SAM-age children at 100% FPL. This child’s SSA has already been “used” in this child’s eligibility test, which passed. As a result, the income used to test the two older children is Dad’s net SSA or $1,180 + the SSA of these two children ($275 x 2 = $550), for total income of $1,730, so these two older children pass at 100% FPL for five.

Mom's eligibility is based on Medically Needy guidelines. The MNIL is determined by adding $392 for the disabled Dad + $584 for the other four family members, or a total MNIL of $976. Dad’s net SSA of $1,180 would be used as income on this Medically Needy budget, but only Mom would be subject to a Share of Cost.

{12/1/09}