165 EXTENDED MEDICAL ASSISTANCE DUE TO EMPLOYMENT (MAM)

Previous Policy

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All individuals who were members of a FANF financial or categorically needy MAGI medical assistance group may receive up to 12 months of extended medical assistance (EMA) without completing a new application, if the assistance group (AG) becomes ineligible for financial or categorically needy MAGI medical assistance and meets the criteria noted under the appropriate heading below

For FANF Financial Assistance Cases:

ineligibility for financial assistance is due to new or increased earnings of the parent/caretaker relative included; or
ineligibility for FANF is due to an increase in the number of hours the principal wage earner is employed.

For Categorically Needy MAGI Medical Assistance Cases:

ineligibility for categorically needy MAGI medical assistance is due to new or increased earnings of the parent/caretaker relative included, or ineligibility for FANF is due to an increase in the number of hours the recipient is employed; and
the AG has received FANF financial or categorically needy MAGI medical assistance during any 3 of the 6 months prior to the month in which the categorically needy MAGI medical assistance case closed.

The reason for the termination of FANF financial or categorically needy MAGI medical assistance must be the employment-related reasons listed above. Extend medical assistance only if there are no changes in program criteria, nonfinancial criteria, or resources that make the AG ineligible at the same time as the employment-related change.

Exception: An individual who is determined by a court to have fraudulently received FANF financial or categorically needy MAGI medical assistance in any of the 6 months immediately preceding the closing of a financial or categorically needy MAGI medical assistance case due to employment related reasons is not eligible for 12-month EMA. Other AG members are also ineligible for 12-month EMA. The penalty stays with each individual from the original AG whether they remain in the same AG or move to another AG. If a penalized individual moves into another AG, the new AG is not penalized—only the original penalized individual.

References: He-W 882.05; RSA 167:82, VI; 42 USC 1396r-6(b); 42 USC 1396u-1(c)(2)