11/17/2017 12:56:12 PM
We have recently learned of cases where assisters did not report members of a household on an application. Knowingly failing to include household members on an application is a violation of your responsibilities as a certified assister and can result in serious consequences for both the consumer and the assister.
The most common situation is an assister failing to include an adult member of the household because that individual was not applying for coverage. Although the adult may not be applying for coverage, the adult’s information is necessary to accurately determine household size and income for those members of the household applying for coverage.
Help prevent fraud by carefully reviewing the following rules regarding reporting household income. (You can review the /assister-central/training/household-composition-income.jsponline training on household composition and income on Assister Central.)
Medical Assistance, MinnesotaCare and assisted QHPs use different rules to determine household composition and household size. As an assister, it is your responsibility to report ALL individuals on the application who are related to the applicant and either live with the applicant or are claimed as a tax dependent by the applicant.
METS will determine which members of the household will be used to determine eligibility based on the information provided on the application.
Every person who is a member of an application’s household must be included on the application:
Even if that person is NOT applying for coverage
Even if that person is applying for coverage on another application
Do not forget to report:
Tax dependents who do not live with the applicant
Married spouses living with the applicant but not applying for coverage
Step-children who live with the applicant
Grandparents who live with the applicant
You should not report others physically living in the household who are not related to any household members or part of the tax filing unit, such as a roommate.
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