TITLE 8 SOCIAL
SERVICES
CHAPTER 292 MEDICAID
ELIGIBILITY - PARENT CARETAKER
PART 400 RECIPIENT
REQUIREMENTS
8.292.400.1 ISSUING AGENCY: New Mexico Human Services Department (HSD).
[8.292.400.1 NMAC - Rp, 8.292.400.1 NMAC, 1/1/2014]
8.292.400.2 SCOPE: The rule applies to the general public.
[8.292.400.2 NMAC - Rp, 8.292.400.2 NMAC, 1/1/2014]
8.292.400.3 STATUTORY AUTHORITY: The New Mexico medicaid program is administered pursuant to regulations promulgated by the federal department of health and human services under Title XIX of the Social Security Act as amended or by state statute. See NMSA 1978, Section 27-1-12 et seq.
[8.292.400.3 NMAC - Rp, 8.292.400.3 NMAC, 1/1/2014]
8.292.400.4 DURATION: Permanent.
[8.292.400.4 NMAC - Rp, 8.292.400.4 NMAC, 1/1/2014]
8.292.400.5 EFFECTIVE DATE: January 1, 2014, unless a later date is cited at the end of a
section.
[8.292.400.5 NMAC - Rp, 8.292.400.5 NMAC, 1/1/2014]
8.292.400.6 OBJECTIVE: The objective of this rule is to provide eligibility guidelines when determining eligibility for the medical assistance division (MAD) medicaid program and other health care programs it administers. Processes for establishing and maintaining this category of eligibility are found in the affordable care general provision chapter located at 8.291.400 NMAC through 8.291.430 NMAC.
[8.292.400.6 NMAC - Rp, 8.292.400.6 NMAC, 1/1/2014]
8.292.400.7 DEFINITIONS: Refer to 8.291.400.7 NMAC.
[8.292.400.7 NMAC - Rp, 8.292.400.7 NMAC, 1/1/2014]
8.292.400.8 MISSION: To transform lives. Working with our partners, we design and deliver innovative, high quality health and human services that improve the security and promote independence for New Mexicans in their communities.
[8.292.400.8 NMAC - Rp, 8.292.400.8 NMAC, 1/1/2014; A, 7/1/2021]
8.292.400.9 WHO CAN BE A RECIPIENT:
To be eligible, an individual must meet specific eligibility
requirements:
A. In accordance with 42 Code of Federal Regulations
(CFR) 435.4 an individual must be a parent or caretaker relative defined as a
relative of a dependent child by blood, adoption, or marriage with whom the
child is living, who assumes primary responsibility for the child's care (as
may, but is not required to, be indicated by claiming the child as a tax
dependent for federal income tax purposes), and who is within the fifth degree
of relationship per Subsection C of 8.291.410.12 NMAC.
B. In accordance
with 42 CFR 435.4 a dependent child is defined as one who
meets both of the following criteria:
(1) is under the age of 18, or;
(2) is age 18 and a full-time student in
secondary school (or equivalent vocational or technical training), if before
attaining age 19 the child may reasonably be expected to complete such school
or training.
C. An
individual who meets the eligibility requirements pursuant to 8.291.400 through
8.291.430 NMAC.
D. Prior to the parent caretaker individual becoming an
eligible recipient, all children listed on an application must meet the
following:
(1) be
evaluated for eligibility for a medicaid program if not already eligible; or
(2) if
not medicaid eligible, have current health insurance coverage that meets
criteria as a qualified health plan.
[8.292.400.9 NMAC - Rp, 8.292.400.9 NMAC, 1/1/2014; A, 7/1/2021]
8.292.400.10 PARENT
CARETAKER ASSISTANCE UNIT AND BUDGET GROUP: To be considered in a
parent caretaker assistance unit, an individual must apply and be determined
eligible. Individuals living with the
parent caretaker who meet criteria in 8.291.430 NMAC are included in the budget
group.
[8.292.400.10 NMAC - Rp, 8.292.400.10 NMAC, 1/1/2014]
HISTORY OF 8.292.400 NMAC:
History of Repealed
Material:
8.292.400 NMAC, Recipient Requirements, filed 9/17/2013 - Duration expired 12/31/2013.