Code of Vermont Rules › Agency 13 - AGENCY OF HUMAN SERVICES › Sub-Agency 170 - DEPARTMENT FOR CHILDREN AND FAMILIES (DCF) › Chapter 430 - MEDICAID, FAMILIES AND CHILDREN (4300) › Section 13 170 430 - MEDICAID, FAMILIES AND CHILDREN (4300)

Current through June, 2024
Section 4300
				Medicaid, Families and Children
Individuals under age 21 or pregnant, as well as parents and
				  caretaker relatives of a dependent child, are categorically eligible for
				  ANFC-related Medicaid if they meet the nonfinancial and financial requirements
				  for participation in the Medicaid program. Nonfinancial requirements include
				  general requirements for Medicaid participation (M100), the criteria for one of
				  the coverage groups identified in M302.2-M303.3, citizenship (M311), Vermont
				  residency (M312), and living arrangement (M313). Individuals meet the financial
				  requirements (M330-M360) if their resources (M340-M344) and income (M350-M353)
				  do not exceed Medicaid limits. Individuals may be able to spend-down excess
				  income or resources and qualify for Medicaid under the ANFC-related medically
				  needy coverage group.
Individuals who meet the criteria in sections M100 and M300
				  are eligible for Medicaid because they meet some or all of the requirements of
				  the Reach Up financial assistance program (formerly Aid to Needy Families with
				  Children), which serves people who are under age 21 or pregnant, as well as
				  parents and caretaker relatives of dependent children. Before terminating
				  Medicaid eligibility of an individual in an ANFC-related coverage group, the
				  department determines the continuing eligibility of individuals under all other
				  applicable Medicaid coverage groups.
Section 4301 Eligibility
Secton 1931 of the Social Security Act is a part of the
				  federal welfare reform law, the Personal Responsibility and Work Opportunity
				  Reconciliation Act of 1996 (PRWORA), which affected ANFC-related Medicaid.
				  Section
				  1931 requires
				  states to apply the Aid to Needy Families with Children (ANFC) eligibility
				  criteria in effect July 16, 1996, to individuals currently seeking ANFC-related
				  Medicaid. When the legislature completed its implementation of PRWORA, it
				  renamed the ANFC program Reach Up. The Reach Up eligibility regulations remain
				  the same as those in effect on July 16, 1996, for ANFC-related Medicaid with
				  two exceptions, specified below. In the M300 sections of ANFC-related Medicaid
				  regulations, wherever the term ANFC is used, it refers to the ANFC criteria in
				  effect July 16, 1996, except where otherwise specifically indicated.
4301.1 Income Maximums.
The ANFC-related Medicaid income maximum is lower than the
				  Reach Up income maximum. For ANFC-related Medicaid eligibility, the department
				  disregards income equal to the difference between the ANFC payment level in
				  effect on July 16, 1996, and the one currently applied in the Reach Up program.
				  The effect of this income disregard is to bring the countable income of all
				  Reach Up participants to a point at or below the July 16, 1996, payment level.
				  Consequently, families participating in Reach Up will be eligible for Medicaid
				  under M300.2(A), below.
4301.2 Deprivation Not Required.
To be eligible for ANFC-related Medicaid, the department no
				  longer requires applicants to establish that a member of the Medicaid group is
				  unemployed, incapacitated or absent.