Alabama Administrative Code › Title 560 - ALABAMA MEDICAID AGENCY › Chapter 560-X-25 - MEDICAID ELIGIBILITY › Section 560-X-25-.15 - Parents And Other Caretaker Relatives And Transitional Medical Assistance

Current through Register Vol. 42, No. 9, June 28, 2024
(1)
Parents and Other Caretaker Relatives (POCR)
(a) Parents and Other Caretaker Relatives is
			 a Medicaid eligibility coverage group available to parents and other caretaker
			 relatives of dependent children with household income at or below 13% of the
			 federal poverty level (FPL). POCR also includes qualified pregnant women
			 without other children whose family income falls within the standards for POCR.
			 A standard income disregard of 5% of the federal poverty level is applied if
			 the individual is not eligible for coverage due to excess income.
(b) The POCR must be related to the dependent
			 child by blood, adoption, or marriage, with whom the dependent child lives, and
			 who has primary responsibility for the dependent child's care. An all-inclusive
			 list of POCR relationships includes:
1. The
			 dependent child's father, mother, grandfather, grandmother, brother, sister,
			 stepfather, stepmother, stepbrother, stepsister, uncle, aunt, first cousin,
			 nephew or niece;
2. The spouse of
			 such POCR, even after the marriage ends due to divorce or death.
(c) A "dependent child" is defined
			 as a child who is under the age of 19.
(d) Self-attestation must be accepted to
			 verify the POCR relationship for caretaker relatives unless there is
			 information that is not reasonably compatible with such attestation. In such
			 cases, the following documents are acceptable to verify POCR relationship:
1. Primary sources: Birth record, school
			 records, sworn, notarized or witnessed statement of applicant/recipient,
			 affidavit of paternity, hospital birth record, court orders signed by the judge
			 where the relationship is acknowledged as claimed and there is no evidence to
			 the contrary. If there are no primary sources to verify the POCR relationship,
			 then the combination of both a Declaration of Natural Relationship Form made by
			 the applicant/recipient or other persons with knowledge of the relationship and
			 a secondary source to verify the POCR relationship
2. Secondary sources: Insurance policy, other
			 agency records, (example Red Cross, SSA, Census records, VA, Department of
			 Senior Services records, Department of Human Resources), bible records, income
			 tax records, official records, (example school report card, juvenile court),
			 other hospital records, clinic or Health Department records, church records,
			 military records, statement from a minister, priest or rabbi, baptismal
			 certificate or other.
(e) Technical Requirements:
1. The dependent child must be living in the
			 home of the POCR.
2. The dependent
			 child must be under age 19.
3. The
			 dependent child must be a U.S. citizen or an alien in satisfactory immigration
			 status.
4. The POCR caretaker must
			 cooperate with the Department of Human Resources and Alabama Medicaid Agency in
			 Medical Support Enforcement Activities and in Third Party Medical Liability
			 Activities unless good cause for not cooperating is determined.
5. When application is made for a dependent
			 child the POCR who cares for the dependent child automatically assigns to the
			 State all medical insurance or medical support benefits to the extent medical
			 assistance is provided to both the dependent child and the POCR.
6. The POCR must furnish all Social Security
			 numbers for everyone in the household or apply for a Social Security number for
			 anyone who does not have a number and furnish the number upon receipt. (These
			 numbers will be used in addition to any other means of identification in the
			 administration of the program as provided for in Section 402(a) (25) of the
			 Social Security Act). The number provided will be used in computer matches,
			 program reviews and audits. Eligibility and income information will be
			 requested regularly from the Internal Revenue Service, Social Security
			 Administration, Alabama Department of Industrial Relations and other public and
			 private organizations.
7. The POCR
			 must apply for any other benefits for which they or other members of the
			 household appear to be eligible, such as Veteran Benefits, Social Security,
			 Unemployment Compensation, etc.
(f) The Agency uses less restrictive income
			 and resource methodologies than those in effect as of July 16, 1996, as
			 follows:
1. Resources are excluded.
2. Gifts and inheritance are considered
			 excluded income.