North Dakota Administrative Code › Title 75 - Department of Human Services › Article 75-02 - Economic Assistance › Chapter 75-02-02.1 - Eligibility for Medicaid › Section 75-02-02.1-08 - Medicaid unit

Current through Supplement No. 393, July, 2024
1. For individuals
				not subject to MAGI-based methodology, a Medicaid unit may be one individual, a
				married couple, or a family with children under twenty-one years of age or, if
				blind or disabled child, under age eighteen, whose income and assets are
				considered in determining eligibility for any member of that unit, without
				regard to whether the members of the unit all physically reside in the same
				location. An applicant or recipient who is also a caretaker of children under
				twenty-one years of age may select the children who will be included in the
				Medicaid unit. Anyone whose needs are included in the unit for any month is
				subject to all Medicaid requirements which may affect the unit. The financial
				responsibility of relatives must be considered with respect to all members of
				the assistance unit.
2. For
				individuals subject to a MAGI-based methodology, a Medicaid unit is determined
				by the individual's tax filing status as well as the individual's relationship
				to those with whom the individual lives.
Each individual will have his or her own Medicaid unit
				  determined as follows:
a. If the
				individual is a tax filer, and is not also claimed as a dependent by someone
				else, the individual's Medicaid unit consists of the individual, the
				individual's spouse, if living with the individual, and anyone the individual
				or his or her spouse claims as a dependent, plus a dependent's spouse that
				lives with them, and any unborn children of a pregnant woman who is included in
				the unit.
b. If the individual is
				claimed as a tax dependent by another, even if the individual files his or her
				own tax return, and does not meet any of the following exceptions, that
				individual's Medicaid unit is the same as the household that claims the
				individual as a dependent, plus the individual's spouse that lives with them
				and any unborn children of a pregnant woman who is included in the unit:
(1) The individual is claimed as a dependent
				by someone other than a spouse, or a natural, adopted, or stepparent;
(2) The individual is under nineteen years
				old and is living with both parents but the parents are not filing a joint
				return; or
(3) The individual is
				under nineteen years old and will be claimed as a dependent by a noncustodial
				parent.
c. If the
				individual is not a tax filer, is not expected to be claimed as a dependent by
				another, or meets one of the conditions set forth in paragraphs 1, 2, or 3 of
				subdivision b, the individual is subject to the nonfiler rules. A nonfiler
				individual's Medicaid unit is the individual, and, if living with the
				individual, the individual's spouse; natural, adopted, or stepchildren under
				nineteen years old; natural, adopted, or stepparents; or natural, adopted, or
				step-siblings under nineteen years old, plus any of their spouses that live
				with them, and any unborn children of a pregnant woman who is in the household.