Caretaker Relatives 510-03-35-15

(Revised 5/1/2017 ML #3498)

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IM 5340

IM 5327

 

(N.D.A.C. Section 75-02-02.1-08.1)

 

1. Caretaker relatives may be eligible for Medicaid under the Parents and Caretakers of deprived children and their spouses category when:
   1. A child is residing with the caretaker/relative AND is eligible for Medicaid, Healthy Steps or enrolled in a health insurance policy which includes the minimal essential coverage’s; and
   2. The caretaker relative assumes primary responsibility for the child’s care (does not mean the caretaker relative must claim the child for tax purposes); and
   3. The caretaker relative is related within the 5th degree of relationship to the child; and
   4. The caretaker relative’s household has income at or below the parent/caretaker and their spouses’ category income level.

When the child is NOT eligible for Medicaid (with no ‘client share’), Healthy Steps or enrolled in a health insurance policy that meets the minimal essential coverage criteria, the caretaker relative is not eligible for any coverage. This policy applies to coverage under Medicaid Expansion in the same way. However, this policy DOES NOT apply to the following:

• A caretaker relative who is a pregnant woman
• A caretaker relative who is eligible under Medically Needy coverage with a ‘client share’;
• A caretaker relative who is eligible for coverage under Emergency Services only;
• A caretaker relative who is eligible under the Breast and Cervical Cancer Early Detection (Women’s Way) Program as defined at 510-05-67.

2. The following individuals may be considered a caretaker relative:
   1. A natural, adoptive, or stepparent;
   2. A grandparent (including a great, great-great, or great-great-great grandparent);
   3. A sibling, half-sibling, or stepsibling (if age sixteen or older);
   4. An aunt or uncle (including a great or great-great aunt or great or great-great uncle);
   5. A niece or nephew (including a great or great-great niece or great or great-great nephew);
   6. A first cousin (an aunt or uncle’s child) or first cousin once removed (an aunt or uncle’s grandchild);
   7. A second cousin (a great aunt or great uncle’s child);
   8. A spouse of any of the above individuals even after the marriage is terminated by death or divorce.

3. A child is considered to be ‘living with’ a caretaker relative when away at school or when otherwise temporarily absent from the home.

4. A child is NOT considered to be living with a caretaker relative when either the child or the caretaker is residing in a nursing care facility, an intermediate care facility for individuals with intellectual disabilities (ICF-IID), or a specialized facility on other than a temporary basis.

5. A child may not be considered to be living with more than one caretaker relative in more than one Medicaid household for the same time period.

6. When the only child in common is an unborn and there is deprivation of unemployment/underemployment, incapacity, or disability, the prospective parents must be married in order for the father to be eligible as a caretaker relative under the Parents and Caretakers of deprived children and their spouses’ category.

7. Termination of parental rights removes all relationships and responsibilities between the parent and the child(ren). The parent becomes a "legal stranger" to the child(ren). However, for Medicaid purposes, the blood relatives of a parent whose parental rights have been terminated continue to be treated as relatives of the child(ren).