0920.010.00  ELIGIBILITY REQUIREMENTS (MHF)

Claimants must meet the Medical Assistance for Families (MAF) eligibilityfactors listed below. MAF eligibility factors not listed here are not eligibilityfactors for this program.

1. Social Security Number.
2. Age of Child
3. Residence
4. Citizenship and Alien Status.
5. Assignment of Medical Support.
6. Cooperation in Pursuit of Medical Support.
7. Need.

The following additional eligibility criteria apply to CHIP children:

• Non-premium and premium children must:
  • Be uninsured; and
  • Pass gross income test.
• Premium group children only must:
  • Be uninsured for 6 months;
  • Have no access to affordable health insurance;
  • Pay a premium; and
  • Have a net worth of $250,000 or less.

0920.010.05  Social Security Number (MHF)

This eligibility factor applies to children eligible for MHF healthcare coverage.  Itdoes not apply to parents or children included in the assistance group who arenot receiving coverage.  Follow instructions outlined in Section 0905.010.05 forthis eligibility factor for children.

While obtaining the SSN is not an eligibility factor under the above provisionfor uncovered parents included in the assistance group, their SSN should berequested as it may be needed to verify income through matches with EmploymentSecurity, Social Security, Child Support Enforcement, etc.

0920.010.10  Age Of Child (MHF)

A child is defined as a person under the age of nineteen. A child remainsage eligible until the date they turn nineteen.

EXCEPTION: If the child is an inpatient in a hospital atthe time s/he becomes ineligible due to age, the child's eligibility continuesuntil the end of the inpatient stay.

0920.010.15  Residence (MHF)

The requirement is the same as for MAF. Refer to Section 0905.010.25.

0920.010.20  Citizenship And Alien Status (MHK)

The requirement is the same as for MHF. Refer to Section 0905.010.30.

0920.010.25  Assignment Of Medical Support (MHF)

This requirement is the same as for MHF. Refer to Section 0905.010.35.

0920.010.30  Cooperation In Pursuit Of Medical Support (MHF)

This requirement is the same as for MHF. Refer to Section 0905.010.40.

0920.010.30.05 Referral To DCSE (MHF)

This requirement is the same as for MHF except a referral to FSD-CS is not required in the following situations:

• A child under the age of 19 who is not living with a caretaker and who applies for MHK in his/her own name; and
• A non-related caretaker applying for a child in their physical custody for whom they do not have legal guardianship or legal custody.

Refer to Section 0905.010.40.05

0920.010.30.10 Cooperation and Referrals When Adding Children (MHF)

This requirement is the same as for MHF. Refer to Section 0905.010.40.10.