215 Relationship

Effective Date:  January 1, 2017

Previous Policy

Relationships of CHIP Household Members

1. An applicant must declare the relationship between household members.  The relationship of household members is a factor used in eligibility decisions.
2. Relationships applicable to medical assistance eligibility include:

• Parent to child.
• Spouse to spouse (legally married, not divorced).
• Sibling to sibling (including biological, adoptive and step-siblings).

1. As CHIP uses MAGI-based methodology, an unrelated person in a household may factor into the eligibility determination (215-3).
2. To determine the MAGI household, see 230-2 and 230-3.

Establishing Relationships of Household Members

1. Accept the client's statement about the relationships of their household members.  They may be living with the individual or temporarily absent.  If the agency has conflicting information, request other verification.
2. If a couple claims they have a common-law marriage, accept the client's statement, unless the agency has conflicting information.
3. If the agency has conflicting information, request verification of relationship.  In some cases, a combination of documents may be required (Table VI).