December 1973 Eligibility Requirements Manual – Table of Contents

1013.000.00 RELATIONSHIPS

IM-77 July 15, 2021; IM-06 January 17, 2020

Marriage

Per RSMo 451.010, a marriage initiated in Missouri must result from a valid civil contract (marriage license) and must not be prohibited by RSMo 451.020 or considered null and void by RSMo 451.040.  A marriage established in another state is recognized in Missouri as long as the marriage was legal in the state in which it was established.  In other words, a person considered legally married in another state is considered legally married in Missouri. D.L.H. v. J.D.H., 521 S.W.3d 324, 326 (Mo. App. 2017).

NOTE:  When reference is made in policy to married or marriage, assume the reference is referring to the above definition.  When reference is made to a spouse, husband, or wife, assume the spouse, husband, or wife is participating in a marriage that meets the above conditions.

Only participants recognized as legally married in Missouri are treated as spouses for MO HealthNet eligibility, if both spouses reside in the home.

Some types of living arrangements may require legal documentation in other states or jurisdictions and are similar to traditional marriages.  However, these arrangements do not meet the provisions of the above definition of marriage or are otherwise considered invalid.  The following arrangements are not legally recognized as marriages in Missouri:

  • Civil union – An arrangement similar to marriage, but not observed on a federal level as a legal marriage. Prior to 2015, in states that recognized civil unions, these unions served as means for same-sex couples to realize some of the same benefits as other married couples. After same-sex marriage bans were found unconstitutional in 2015 as a result of Obergefell v. Hodges, some states converted civil unions to marriages
  • Domestic partnership – Some jurisdictions allow couples to register as a domestic partnership. Many employers offer benefits based on domestic partnerships and laws differ in how these are treated and recognized. 

 

Marital Relationships

When determining eligibility for MHABD, a spousal relationship affects various points of eligibility for both spouses.  Some descriptions of spousal and/or spouse-like relationships are below.

  • Spouse – One of two partners in a marriage. Request a copy of a valid marriage license for current marriages.
  • Ex-spouse – A former spouse. When in question, request a divorce decree to verify a marriage has been ended by a court.
  • Separated spouses – Spouses living apart due to marital difficulties. Treat separated participants as single person households.   Do not consider spouses involuntarily separated due to illness, employment, education, deployment, etc. as separated spouses.
    • Legal separation – A marital separation recognized by the court.

NOTE:  Submit all relevant details for common law marriages through the IM-14 process before establishing a marital relationship. Include the date of marriage and the state in which the marriage was established. Include any documentation of the marriage the participant(s) can provide. Documentation could include, but is not limited to, tax records, marriage agreements, proof of joint ownership of property, or proof of co-habitation.

 

Familial Relationships

Other relationships may affect MO HealthNet eligibility or processing procedures.  Establish relationships of household members prior to determining eligibility for MO HealthNet.

  • Parent – The father or mother of a participant, whether by blood or adoption. When determining eligibility for a child under the age of 18, verify this relationship if one or both parents are in the home.  For other determinations, verify when this relationship is in question.
  • Step-parent – A person married to a participant’s father or mother who is not the biological or adoptive father or mother of the participant. When determining eligibility for a child under the age of 18, verify this relationship if the step-parent resides in the home with the participant.
  • Siblings – Individuals with 2 parents in common, whether by blood or adoption. Verify this relationship when in question if the relationship affects eligibility or case processing.
  • Half-Siblings – Individuals with one parent in common, whether by blood or adoption. Verify this relationship when in question if the relationship affects eligibility or case processing.
  • Step-Sibling – The child (whether biological or adopted) of a participant’s step-parent. Verify this relationship when in question if the relationship affects eligibility or case processing.
  • Relative – A member of a participant’s family by blood, marriage, or adoption. Verify this relationship when in question if the relationship affects eligibility or case processing.

 

Legal Relationships

Aged, disabled, or deceased participants often have an appointed representative to manage financial and/or personal affairs. 

  • Power of Attorney (POA) – Sometimes known as attorney-in-fact. A POA is an individual appointed by a participant to act on his/her behalf in various circumstances.  Verify a power of attorney relationship with a copy of the POA document signed by the participant and the POA.

The scope of a power of attorney is limited by what type of POA the participant chooses to appoint. 

  • Limited – A limited POA can act on someone’s behalf for a specified purpose, such as signing a title or a deed.
  • General – A general POA can perform a broader array of functions such as manage finances, sign documents, and/or submit applications.
  • Durable – A durable POA can be general or limited depending on the participant’s preference, but the powers given to the POA continue in the event the participant becomes incapacitated.
  • Medical – A medical POA is limited to making medical treatment decisions on behalf of a participant. These are usually durable POAs as the powers continue after the participant has become incapacitated.

Verify the following legal relationships with court documentation:

  • Guardian – An individual appointed by a court to manage a participant’s personal affairs, such as placement in a group home or decisions concerning healthcare, etc.
    • Ward – an individual with a court appointed guardian to manage the individual’s personal affairs.
      • NOTE: Do not require documentation of this relationship if the ward is a child, unless the relationship is in question.
  • Conservator – An individual appointed by a court to manage a participant’s financial affairs such as managing funds in a bank account or setting up a trust, etc.
    • Conservatee – an individual with a court appointed conservator to manage the individual’s financial affairs.
  • Public Administrator – A county employee who acts as guardian and/or conservator for a participant.
  • Administrator – A person appointed by the court to handle the estate of a deceased participant.
  • Executor or Personal Representative – A person named in a will to manage disposition of a participant’s property after his/her death.