Department of Human Services: Chapter 4: Section 4.1 thru 4.3
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IMA POLICY MANUAL
PART IV: NON-FINANCIAL ELIGIBILITY REQUIREMENTS
 
CHAPTER 4: AGE/SCHOOL ATTENDANCE 
 
INTRODUCTION 4.1
 
Age and school attendance are eligibility factors for some programs. In some cases, age may not be an eligibility factor, but it may impact what disregards and deductions the individual receives. For some programs, school attendance can make an individual ineligible while for others, school attendance is required in order for an individual to be eligible.
 

LEGAL AUTHORITY 4.2
 
AREA/TOPIC DISTRICT FEDERAL
Age
TANF: DC Code 4-205.15
 
GC: See TANF and
DC Code 4-205.5a.
MA: 42 USC 1396a(a)(10); 42 USC 1396a(l); 42 USC 1396d(a); 42 USC 1396u-1; 42 USC 1396a(m); 42 CFR 435.4, 435.520
 
TANF: 45 CFR 260.30
 
FS: 7 USC 2012 (f); 2014 (c); 2014 (e); 2014 (g); 7 CFR 273.8(b); 273.9(a); 273.9(d)
School Attendance and Student Status
TANF: DC Code
4-205.15, 4-205.65-.66
 
GC: DC Code 4-205.5a;
34205.15
TANF: 42 USC 608 (a)(4);
45 CFR 261.33
 
FS: 7 USC 2015 (e); 7 CFR 273.5(b)
 

 AGE 4.3
 
MA 
Age is an eligibility factor for certain MA categories. A person remains eligible with respect to age for the entire month in which s/he reaches the maximum age even if the birthday is the first of the month.
 
AR: A child in an AR unit must be under the age of 21. Children ages 19 and 20 are eligible for Medicaid if they have incomes under 200% of the FPL.
 
AX: A child in an AX unit must be under the age of 19.
 
SR: An individual must be age 65 or older to meet SR eligibility on the basis of age. There is no age requirement for an individual who is statutorily blind or permanently and totally disabled. However, if the disabled person is under age 21 or the individual is a parent or caretaker relative, his/her Medicaid eligibility should be evaluated under the AR and AX program types first. If the individual is eligible based on the AR or AX program types, the individual’s Medicaid application should be approved.  The individual should be strongly encouraged to complete the medical evaluation form because if the MRT determines the individual disabled and the case is converted to an SR case, the individual will not be placed in the same managed care system that serves non-disabled Medicaid participants.  This system may not be appropriate for individuals with disabilities.  (If the individual's income - after the appropriate deductions - exceeds the SR standard for a household of one, the individual does not need to complete a medical evaluation form.)
 
QM:  Age does not need to be verified, though eligibility for Medicare, an age-related benefit itself, must be verified.
 
TANF 
Age is an eligibility factor, but there is no age requirement for the parent/caretaker relative.
 
A child must be under age 18.  However, an 18-year-old child can, at the option of the group, be included in the group if s/he:
  • meets the requirement in Section 4.4: School Attendance and Student Status in this Chapter (that is, the child must be enrolled and physically attending school),
  • is reasonably expected to graduate before reaching 19 or in the month s/he turns 19, or
  • has not graduated from high school but is a full-time student in a training program and is reasonably expected to finish the program before reaching 19 or in the month s/he turns 19.
GC
See TANF
 
FS  
Age is not an eligibility factor for FS but must be considered in certain situations.  FS groups that include a person who is 60 or older are:
  • not required to meet the gross income test (see Section 8.4:  Determining Income-Eligibility in Part VI);
  • entitled, under some circumstances, to a higher shelter deduction (see Section 6.3:  Income Disregards and Deductions in Part VI);
  • subject to a higher resource limit (see Exhibit VI-2); and 
  • entitled to an Excess Medical Deduction if the elderly individual's medical expenses exceed $35 per month (see Section 6.3:  Income Disregards and Deductions in Part VI).