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Eligibility Basics: Household Size

MA-EPD policy regarding household size differs from regular MA policy for married couples.

If both spouses are applying for MA-EPD, each spouse has a household size of one (or more if there are children in the home).

Note: Any mutual children of the couple are counted in each spouse's household size.

If only one spouse is applying for MA-EPD, use the same policy for determining household size as you do for MA.

When calculating income for MA-EPD, you only count the income of the individual applying. Do not deem the income of their spouse or children.

 

MA-EPD and Home and Community-Based Waivers

Often, enrollees who receive services through one of the Disability Home and Community-Based Waivers (CADI, CAC, DD, BI or EW) are also eligible for MA-EPD. Determining the correct household size in these situations can seem confusing. Waivers generally require a household size of one, yet MA-EPD allows for larger household sizes when there are spouses and/or children on the case.

MA-EPD enrollees who are also on any one of these Home and Community-Based waivers mentioned above should ALWAYS use the household size determined by MA-EPD rules. This may require you, as the worker, to FIAT the health care eligibility results in MAXIS to change the household size. MAXIS determines a household size of one for these enrollees based on the coding of the Home and Community-Based Waiver field on STAT/DISA. If the worker determines that, based on the MA-EPD rules, the household size should be something different, the household size in the health care eligibility results should be adjusted using FIAT.

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