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Medicaid Eligibility for Children - Resources – Iowa

Disregard the resources of all household members when determining eligibility for children in the coverage groups specified below. Continue to count resources when determining eligibility for children in all other coverage groups.

The age limit for determining if a person is a child or an adult is the age limit for the coverage group under which Medicaid is being received or under which eligibility is being explored or established. See Iowa Dept of Human Services Employee Manual Title 8, Chapter F, Coverage Groups, for more information.

The following chart lists all coverage groups under which children can establish eligibility and whether household resources are disregarded or counted in determining children’s eligibility.

Examples:

1. The C family applies for the HCBS MR waiver for Child C. Child C is the grantor and beneficiary of a trust with a countable value of $197, 345. Income produced by the trust is countable, not excluded. If all other eligibility factors are met, Child C is eligible under the 300% group, since household resources are disregarded in determining children’s eligibility under this group.

2. Child B, age 15, lives in an ICF/MR and is eligible for Medicaid and facility care under the coverage group for people who are ineligible for SSI due to residence in a medical institution.

Child B has countable monthly income of $100 and countable resources of $1,800.

At the annual review, the worker determines that Child B’s countable resources now total $2,100. Since Child B is no longer eligible under this coverage group, the worker completes an automatic redetermination.

Child B can be determined eligible under the 300% group, since resources are not an eligibility factor for children in the 300% group and because Child B’s income exceeds the SSI maximum for a person in a medical institution ($30).

3. Mrs. A and her two children, ages 6 and 8, apply for Medicaid. Countable income is under the FMAP limit for a three-member household. Mrs. A reports the following household resources:

 Savings account of the 6-year-old   $ 200

 Savings account of the 8-year-old   $ 300

 Mrs. A’s checking account    $ 50

 1990 Chevrolet Impala    $3,500 equity value

 1992 travel trailer     $5,000

In determining FMAP eligibility for the children, household resources are disregarded. The children are eligible for Medicaid under FMAP. In determining FMAP eligibility for Mrs. A, the countable value of household resources is $9,050. Mrs. A is not eligible under FMAP. She is eligible under Medically Needy with zero spenddown.

4. Household composition:

Child D, age 10

Mr. D, father of Child D

Mrs. D, mother of Child D

The Ds file an application for Medicaid. Mr. D was injured in an automobile accident and has no health insurance. He is at home and is unable to work. Child D is the grantor and beneficiary of a trust with a countable value of $97,755. The trust is purchasing health insurance for Child D.

The Ds can choose to voluntarily exclude Child D so that the trust will not be a countable resource in determining eligibility for Mr. and Mrs. D. The Ds’ countable resources then total $843. If all other eligibility factors are met, Mr. and Mrs. D are eligible for Medicaid under FMAP, since their countable resources are within FMAP limits.

See Also:

·           Overview of Medical Assistance in Iowa

·           Welcome and Introduction to Benefits in Iowa

Source: Iowa Dept of Human Services Employees Manual

Title 8 Medicaid

·                        Chapter F, Coverage Groups

Legal references: 441 IAC 75.1(7)"a"(4), 75.1(7)"b," 75.1(14)"a," 75.1(15) a," 75.1(17), 75.1(28)"b," 75.1(35)"a"(2), 75.1(35)"a"(3), 75.1(35)"b"(1), 75.1(35)"c"(3), 75.13(2), 75.13(3), 75.56(1), 83.2(1)"c"

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