215 Relationship

Effective Date:  January 1, 2017

Previous Policy

1     Relationships of CHIP Household Members

A          An applicant must declare the relationship between household members.  The relationship of household members is a factor used in eligibility decisions.

B           Relationships applicable to medical assistance eligibility include:

o      Parent to child.

o      Spouse to spouse (legally married, not divorced).

o      Sibling to sibling (including biological, adoptive and step-siblings).

C          As CHIP uses MAGI-based methodology, an unrelated person in a household may factor into the eligibility determination (215-3).

D          To determine the MAGI household, see 230-2 and 230-3.

2     Establishing Relationships of Household Members

A           Accept the client's statement about the relationships of their household members.  They may be living with the client or temporarily absent.  If the agency has conflicting information, request other verification.

B           If a couple claims they have a common-law marriage, accept the client's statement, unless the agency has conflicting information.

C          If the agency has conflicting information, request verification of relationship.  In some cases, a combination of documents may be required (Table VI).