0910.010.00  ELIGIBILITY FOR INITIAL SIX MONTHS (TMA)

To initially qualify for Transitional Medical Assistance, a family must:

1. be eligible to receive and have received MAF (with or without cash) in at least three of the last six months immediately preceding the first month of ineligibility; AND
2. lose eligibility for MAF because one of the following occurred:
   1. employment of a caretaker relative, as defined below;
   2. increased earnings of a caretaker relative; or
   3. loss of the $30 and 1/3 disregard, $30 disregard, or 2/3 disregard by any assistance group member.

The client’s statement of employment and the date employment began may be accepted. If verification is requested (combination MAF/Temporary Assistance case) but not received, determine eligibility for Transitional Medical Assistance based on the best information available from the family or other sources.

If more than one change occurs that could cause MAF ineligibility, use the change occurring first to determine eligibility for Transitional Medical Assistance.

0910.010.05  Receipt Of MAF In Three Of Last Six Months (TMA)

A family must have received and been eligible for MAF (with or without cash) in at least three of the last six months immediately preceding the first month of MAF ineligibility. The family must have met all MAF eligibility criteria in the three months and have been approved for MC+ healthcare coverage on that basis. Months of prior quarter MAF are included in the three months needed to establish eligibility for Transitional Medical Assistance.

A family determined ineligible for MAF in the month of application due to one of the reasons in Section 0910.010.00 may receive Transitional Medical Assistance if eligible for prior quarter coverage. In this situation, approve the MAF application beginning MC+ healthcare coverage at the earliest date eligibility existed in the prior quarter (the family does not need unpaid medical expenses to qualify for this coverage). Close the MAF case the next day and change to Transitional Medical Assistance.

In determining whether the assistance group meets three of the last six months MAF receipt requirement, review the six months ending with the last month the MAF group correctly received MAF. Transitional Medical Assistance eligibility begins the month following the last correctly received MAF.

EXAMPLE: Ms. Green reports July 25 she went to work on the 21st. Ms. Green is a caretaker relative whose earnings cause ineligibility. To stop MAF eligibility an advance notice is necessary. Ms. Green correctly receives MAF in August. If Ms. Green correctly received MAF in three months during the period of March through August, she is eligible for Transitional Medical Assistance (assuming all other eligibility requirements are met). The first month of Transitional Medical Assistance eligibility is September.

0910.010.10  Eligible Family Members (TMA)

Only members of the MAF assistance group, including SSI children receiving MAF, at the time of the MAF closing qualify for Transitional Medical Assistance.

0910.010.15  Caretaker Relative (TMA)

Caretaker relative is defined as any assistance group member who qualifies as the payee in the MAF case (i.e., parents or specified relatives of dependent children). Also included in this definition is a minor parent who qualifies as the payee except for the receipt of MAF benefits by his/her parent.

Unrelated legal guardians are not included in this definition. If earnings of an unrelated legal guardian would cause ineligibility for the child(ren), remove the guardian from the assistance group and continue MAF for the children.

NOTE: Stepparent earnings deemed to an assistance group do not qualify a family for Transitional Medical Assistance.

0910.010.20  Notification Of Initial TMA Eligibility

When a family qualifies for Transitional Medical Assistance, do the following.

1. If in contact with the claimant prior to their MAF case closing, discuss the availability of Transitional Medical Assistance and his/her responsibilities while receiving these benefits.
2. Notify the family in writing of the closing of its MAF case. Include a statement about eligibility for Transitional Medical Assistance for the first six months, and the possibility of Transitional Medical Assistance for an additional six months. Include a copy of the Transitional Medical Assistance attachment to fulfill all the Transitional Medical Assistance notice requirements at MAF closing.