Eligibility Online Manual

M1204C 4 Month Extended Medicaid

Purpose: This section will assist in determining whether individuals are eligible for 4 Month Extended Medicaid benefits.

Current Policy Effective Date: October 1, 2022

Date Last Reviewed: September 21, 2022

Previous Policy: January 1, 2014


1. Adults Must Have Child(ren) In Household

Adults must be a caretaker relative in the household of a child under the age of 18.

2. Assistance Unit Must Have Received Family MAGI Benefits

The assistant unit must have received Family MAGI benefits for at least three months within the six previous months.

3. Applicants Must Be Over Income Standard

Countable income must be more than the Family MAGI income standard. Refer to Medicaid Table 1. Refer to Section M901 to determine if income is countable.

The increased income must be related to the assistance unit either:

    • Beginning to receive spousal support.

    • OR

    • Spousal support payments increasing.

4. Applicants Do Not Have Resource Test

5. Applicants Do Not Have To Cooperate With Child Support

6. Benefits Begin Month After Family MAGI Benefits End

7. Clients Must Be Reviewed

Clients must be reviewed at the end of 4 months to determine continued eligibility in another Medicaid program. Refer to Section M1403 for information on reviewing eligibility.

8. Benefits May Be Authorized For Four Months

Benefits end in the fifth month for individuals age 19 or older, unless they meet eligibility under another group. Benefits must continue for the child(ren) until adult eligibility ends, unless they meet eligibility under another group.

9. Clients May Lose Benefits

The case will be closed on the first day of the following month when any of the following occur:

    • Client does not complete review.

    • Eligible child leaves home

    • Eligible child turns 18

    • Client dies.

    • Client moves out of state.

    • Client determined no longer eligible.

    • Four month period ends and client is no longer eligible.

10. Clients May Be Suspended

    • Clients who are reported as incarcerated in a jail or prison will have benefits suspended until they are released.


Defining Group: Social Security Act § 1925

Social Security Act § 1902(e)(12)

Reviewing Eligibility: 42 CFR 435.916

Clarifying Information:

1. Resource Transfer Provisions Do Not Apply.

2. Reporting Requirements Do Not Need To Be Met.

Worker Responsibilities:

Closing Cases-

Send 15 day closure notice when an adverse action has occurred.