MAP Family Size Policy

Determination of Family Size Policy

Purpose: To appropriately determine family size for eligibility purposes for the Medical Access Program (MAP).

I.  Definition of Family Unit

A.     Family of One

1.  An adult living alone.

2.  An emancipated minor. The emancipated determination is a legal process in which a judge can decide that a minor has the same legal rights as an adult and covers a person who is under age 18, has been married and the marriage has not been annulled.

3.  An adult living with others who are not legally responsible for the adult’s support.

4.  A minor child living alone or with others who are not responsible for the child’s support.

B.      Two or More

1.  Two or more persons living together, except for temporary absences, who are legally responsible for the support of the other person.  Legally responsibility for support exists between:

a)  Persons who are legally married, including minors and same-sex marriages.

b)  Persons who are in a legal, informal marriage (a.k.a. common-law marriage). In a legal informal marriage, both parties must:

(1) live together in Texas;

(2) represent to the public that they are husband and wife; and

(3) be free to marry.

c)  One or both legal parents, including minors, and their legal minor children.

d)  A legal guardian, a minor child, and the legal guardian’s spouse and other legal minor children, if any.

e)  One or both adult caretakers of minors and the caretaker’s legal minor children. Note: A caretaker is one or both adult(s) who perform parental functions for a minor. Parental functions are the provision of food, clothing, shelter, and supervision of the minor.

f)  A pregnant minor child living alone or with others, including the minor’s parent(s). The minor’s parents’ (‘s) family size excludes the pregnant minor.

C.  Additionally count the following:

1.  Minor children who are siblings

2.  An unborn child if individual is not seeking pregnancy termination. Proof of the pregnancy is not needed.

II.  Proof Required

A.  The following documentation serves dual purposes for minors, U.S. residency and familial relationship, except where noted:

1.  Birth certificate

2.  Hospital birth record

3.  Medicaid letter from HHSC

4.  Internal guardianship letter*

5.  Child Protective Services (CPS) documentation*

6.  School records*

7.  Notarized statement from parent releasing the child to other individuals*

8.  Court documents

9.  Baptismal certificate

10. Legal Permanent Resident Card

11. Passport

12. Immigration Forms

*Proof of familial relationship only.

III.  Special Conditions or Exceptions

A.  Program Representatives may make an exception for clients who are unable to secure the required documentation. The following document can be accepted on a one-time-basis to meet the familial relationship requirement:

1.  Birth Certificate and/or ID Form (exception valid for 1 year)

2.  A one-time exception document may be accepted an additional time only if the exception was used by a Central Health staff member or a different submitting agency and the exception is being used for the first time by the Community Partner submitting the Virtual Application.

3. All exceptions must be noted in the eligibility database in the Notes Section.