N.J. Admin. Code § 10:69-10.4

Current through Register Vol. 56, No. 21, November 4, 2024

Section 10:69-10.4 - Eligible unit; all related Medicaid programs

(a) The eligible unit shall be comprised of those family members who apply for and are eligible to receive AFDC-related Medicaid program. It shall include one or more eligible children unless such child is a related Medicaid program beneficiary of SSI benefits.

1. The eligible unit for AFDC-C or -F related Medicaid program shall include any blood-related or adoptive brothers and/or sisters living in the same household and who are otherwise eligible for AFDC-C or -F related Medicaid program. This requirement does not apply to stepbrothers and stepsisters.

2. A stepparent of the children for whom AFDC-related Medicaid program is sought may be included in the eligible unit if the provisions of N.J.A.C. 10:69-10.33 apply. If the non-needy stepparent marries the AFDC-C related Medicaid program beneficiary parent on or after October 1, 1992, and the provisions of N.J.A.C. 10:69-3.7 apply, the stepparent and his or her natural or adoptive children, as well as the natural or adoptive AFDC-C related Medicaid program beneficiary parent, shall be excluded from the eligible unit.

(b) When a related Medicaid program beneficiary of SSI payments is a family member, he or she shall not be included in the eligible unit.

1. When all eligibility factors are present in a family of two or more people, the individuals not receiving SSI benefits shall comprise the eligible unit. This applies to a parent as well as to a child.

(c) An adult who incurs a penalty of ineligibility shall not be included in the eligible unit (see 10:69-10.28) .

(d) The eligible unit shall include the parent(s) and/or needy parent-person(s) with whom the eligible children live, unless such parent has incurred a penalty of ineligibility (see 10:69-10.28) , is an SSI beneficiary, is an ineligible alien (see 10:69-3.9) or is an AFDC-C related Medicaid program beneficiary parent who married on or after October 1, 1992 and is excluded from AFDC-related Medicaid program eligibility in accordance with the provisions of 10:69-10.33.

(e) If a natural or adoptive AFDC-C related Medicaid program beneficiary parent marries a non-needy individual who is not the natural or adoptive parent of one or more of the related Medicaid program beneficiary parent's children prior to October 1, 1992. The provisions are in 10:69-10.33.

N.J. Admin. Code § 10:69-10.4

Amended by 49 N.J.R. 3729(a), effective 12/4/2017