167.13 Changes in Assistance Group Composition (MAM)

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If the assistance group reports the birth of a child or a new individual joins the household, determine the new individual's eligibility for medical assistance separately from the extended medical assistance group. Do not add newborn children or other new individuals to the original extended medical assistance group.

Exceptions:

• If the new individual is a legally liable relative, count the individual's earned income as available to support their children in the extended medical assistance group.

• If an individual in the original extended medical assistance group leaves the household and later returns, add the individual back into the group, if eligible.

When there is a change in assistance group composition during a three-month report period, use average group size to determine the appropriate income limit. Determine average group size as follows:

• add together the number of individuals in the assistance group for each of the 3 months in the period,

• divide the sum by 3, and

• round the result, as follows:

• drop decimals of .49 or less.

• round decimals of .50 or more up to the next whole number.

Example

There are 6 people in the extended medical assistance group in months 1 and 2 of the three-month report period. In month 3, there are only 4 people. The average size is calculated as follows:

1. 6 + 6 + 4 = 16

2. 16 ÷ 3 = 5.33

3. .33 £ .49

     Average size = 5

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