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Florida Administrative Code (Last Updated: October 28, 2024) |
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65. Department of Children and Families |
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65A. Economic Self-Sufficiency Program |
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65A-1. Public Assistance Programs |
1(1) The Family-Related Medicaid technical eligibility factors.
8(a) The age criteria for children is specified in Rule 1865A-1.703, 19F.A.C.
20(b) The individual must be a resident of Florida as required by subsection 1902(a)(16) of the Social Security Act. Individuals who are physically present in Florida on a temporary basis may be considered residents of the State on a case-by-case basis if they indicate an intent to remain in Florida. A lawfully residing child under the age of 19 is considered to meet the residency requirement for Medicaid.
88(c) 89An absence from the home of less than 30 days does not affect Medicaid eligibility. An individual is considered to be temporarily absent and may be eligible for Medicaid, under the following conditions:
1221. The parent or relative continues to exercise care and control of the child during the absence.
1392. A definite plan exists for the absent child or parent/relative to return to the home at the end of the temporary period.
162(d) 163The individual must be a citizen of the United States, or a qualified non-citizen, or a lawfully residing child as defined in Rule 18665A-1.701 187F.A.C.
188(e) 189The identity of each U.S. citizen, or qualified non-citizen, applying for or receiving Medicaid must be documented and verified.
208(2) Standard Filing Unit (SFU).
213(a) Taxpayers not claimed as a tax dependent: For individuals who expect to file a tax return for the taxable year in which an initial determination or renewal of eligibility is being made, and who do not expect to be claimed as a tax dependent by another taxpayer, the SFU consists of the taxpayer and, subject to paragraph (e) of this section, all persons whom such individual expects to claim as a tax dependent.
287(b) Individuals claimed as a tax dependent: For individuals who expect to be claimed as a tax dependent by another taxpayer for the taxable year in which an initial determination or renewal of eligibility is being made, the SFU consists of the taxpayer claiming such individual as a tax dependent, except that the SFU must be determined in accordance with paragraph (c) of this section. Such individuals include:
3551. Individuals other than a spouse or a natural, adopted, or stepchild who expect to be claimed as a tax dependent by another taxpayer;
3792. Individuals under age 19, or in the case of full-time students under age 21, who expect to be claimed by one parent as a tax dependent and are living with both parents but whose parents do not expect to file a joint tax return; and
4253. Individuals under age 19, or in the case of full-time students under age 21, who expect to be claimed as a tax dependent by a parent not living in the home. For purposes of this subparagraph:
462a. A court order or binding separation, divorce, or custody agreement establishing physical custody controls; or
478b. If there is no such order or agreement or in the event of a shared custody agreement, the custodial parent is the parent with whom the child spends most nights.
509(c) Individuals who neither file a tax return nor are claimed as a tax dependent. In the case of individuals who do not expect to file a federal tax return and do not expect to be claimed as a tax dependent for the taxable year in which an initial determination or renewal of eligibility is being made, or who are described in subparagraph (4)(b)1., (4)(b)2., or (4)(b)3. of this section, the SFU consists of the individual and, if living with the individual:
5911. The individual’s spouse;
5952. The individual's natural, adopted or stepchildren under age 19 or, in the case of full-time students, age 21; and
6153. Individuals under age 19, or in the case of full-time students under age 21, the individual's natural, adoptive, and stepparents and natural, adoptive, and stepsiblings under age 19, or in the case of full-time students under age 21.
654(d) Married couples. In the case of a married couple living together, each spouse will be included in the SFU of the other spouse, regardless of whether they expect to file a joint tax return.
689(e) 690If the taxpayer cannot reasonably establish that another individual is a tax dependent of the taxpayer for the taxable year in which Medicaid eligibility is being determined, the inclusion of the individual in the SFU of the taxpayer is determined in accordance with paragraph (c) of this section.
738Rulemaking Authority 740409.818, 741409.919 FS. 743Law Implemented 745409.902, 746409.903, 747409.904, 748409.818, 749409.919 FS. 751History–New 10-8-97, Amended 9-28-98, 4-5-99, 11-23-99, 2-15-01, 9-24-01, 4-1-03, 6-26-08, 9-16-08, 2-26-20.
