WAC 388-408-0055
Medical assistance units. (1) One or
more medical assistance units (MAU) is established for
individuals living in the same household based on the type of
medical program, each individual's relationship to other
family members, and the individual's financial responsibility
for the other family members.
(2) Financial responsibility applies only to spouses and
to parents, as follows:
(a) Married persons, living together are financially
responsible for each other; and
(b) Persons who meet the definition of a natural,
adoptive, or step-parent described in WAC 388-454-0010 are
financially responsible for their unmarried, minor children
living in the same household.
(3) Minor children are not financially responsible for
their parents or for their siblings.
(4) When determining eligibility for family, pregnancy,
or children's medical programs, follow the income rules as
described in WAC 388-450-0106 (1) through (7). Only one MAU
is required when all family members are eligible for
categorically needy (CN) medical coverage.
(5) If a family is not eligible as one MAU for a CN
program, separate MAUs are required for family members living
in the same household in the following situations:
(a) A pregnant minor, regardless of whether she lives
with her parent(s);
(b) A child with earned or unearned income;
(c) A child with resources which make another family
member ineligible for medical assistance;
(d) A child of unmarried parents when both parents reside
with the child;
(e) Each unmarried parent of a child in common, plus any
of their children who are not in separate MAUs;
(f) A caretaker relative that is not financially
responsible for the support of the child;
(6) For a family with multiple MAUs established based on
the criteria described in subsection (5) of this section, a
parent's:
(a) Income up to one hundred percent of the Federal
Poverty Level (FPL) is allocated to the parent and other
members of the parent's MAU. The excess is allocated to their
children in separate MAUs.
(b) Resources are allocated equally to the parent and all
persons in the parent's household for whom the parent is
financially responsible. This includes family members in
separate MAUs.
(7) The exceptions to the income allocations described in
subsection (6) of this section are as follows:
(a) Only the parent's income actually contributed to a
pregnant minor is considered income to the minor.
(b) A parent's financial responsibility is limited when
the minor child is receiving inpatient chemical dependency or
mental health treatment. Only the income a parent chooses to
contribute to the child is considered available when:
(i) The treatment is expected to last ninety days or
more;
(ii) The child is in court-ordered, out-of-home care in
accordance with chapter 13.34 RCW; or
(iii) The department determines the parents are not
exercising responsibility for the care and control of the
child.
(8) When determining eligibility for an SSI-related
medical program, a separate MAU is required for:
(a) SSI recipients;
(b) An SSI-related person who has not been found eligible
for family medical under this chapter; or
(c) The purpose of applying medical income standards for
an:
(i) SSI-related applicant whose spouse is not relatable
to SSI or is not applying for SSI-related medical; and
(ii) Ineligible spouse of an SSI recipient.
(9) For a person in a separate MAU, based on the criteria
described in subsection (8) of this section, the income and
resource allocations described in subsection (6) of this
section are not used. The SSI-related individual's
eligibility is determined using the allocations or deeming
rules in chapter 388-475 WAC.
(10) Countable income for medical programs:
(a) For SSI individuals is described in chapter 388-475
WAC; or
(b) For family medical, pregnancy medical, and children's
medical is described in WAC 388-450-0210.
[Statutory Authority: RCW 74.04.050, 74.04.057, 74.08.090,
74.09.530, and 74.09.055 as amended by 2006 c 24. 07-11-044,
§ 388-408-0055, filed 5/9/07, effective 6/9/07. Statutory
Authority: RCW 74.04.050, 74.04.057, 74.08.090, and 74.09.530. 06-04-021, § 388-408-0055, filed 1/23/06,
effective 2/23/06. Statutory Authority: RCW 74.08.090,
74.08A.100, 74.09.080, and 74.09.415. 02-17-030, §
388-408-0055, filed 8/12/02, effective 9/12/02. Statutory
Authority: RCW 74.04.050, 74.04.055, 74.04.057 and 74.08.090.
98-16-044, § 388-408-0055, filed 7/31/98, effective 9/1/98. Formerly WAC 388-506-0610, 388-506-0630 and 388-507-0730.]