Family Healthcare (FAMIS) Manual

0955.005.40 AGE (MACC)

IM-87 December 6, 1993

Individuals are eligible for MACC up to age 21. However, DYS and the juvenile courts usually do not maintain custody past age 18 and DMH children usually qualify for MA at age 18.

  1. FOR CHILDREN ELIGIBLE UNDER THE POVERTY LEVEL INCOME GUIDELINES:Beginning July 1, 1990, any child below the age of (6) six is covered under this program at 133% of the federal poverty income level.

    Effective July 1, 1991, any child, age 6 or over, born after September 30, 1983, up to age (19) nineteen, is provided Medicaid coverage if family income is below 100% of the federal poverty income level.

    Effective January 1, 1994, the “born after September 30, 1983” provision was eliminated. This allows Medicaid coverage for children age six (6) up to age (19) nineteen, if family income is below 100% of the federal poverty income level.

    Effective January 1, 1994, any child below the age of (1) one is covered under this program at 185% of the federal poverty income level.

    EXCEPTION: If the child is an inpatient in a hospital at the time (s)he would become ineligible due to age, then the child’s eligibility will continue until the end of his or her inpatient stay if all other eligibility is met.

    The caseworker will be notified of children turning (6) six years of age two months prior to their birthdate on the “Caseload Management Worksheet”. The caption on the Caseload Management Worksheet will read “Poverty-Turning 6.” The caseworker must do a budget at 100% of the federal poverty level to determine eligibility. If the case is ineligible, send an IM-80 to close the case.

  2. CHILDREN OVER AGE 18:For these children, eligibility on the basis of need will be made by comparing the family’s income to the MAF standards.