To access the latest version of the MS Excel Family Coverage Worksheet, RIGHT click the link below and click on "Save Target As". You can then save it onto your computer by choosing the location to save your file.  Click SAVE.

*Be sure you choose the correct budget based on your benefit month.*

Family Coverage Budget Worksheet-April 2004 and forward

Instructions For the Family Coverage Worksheet:

The entry in line four (4) is the count month that this Individual had earned income used in the Family Coverage budget (e.g. Case is being worked for August, 2001. If the individual has had earned income used in the Family Coverage Budget for April, May, June, July, and August of 2001, the number that would be entered is 5.)

When utilizing this Spreadsheet, the current Medicaid Budgeting rules for Family Coverage must be applied.

If the case has only one (1) budget unit, enter the information in the appropriate fields and the calculation is completed.

If the case has more than one (1) budget unit, a Spreadsheet must be completed for each budget unit. After the Spreadsheets for each budget unit are completed, if deeming of income can occur between any of the budget units:

For the budget unit that income is deemed FROM, manually subtract the deemed amount from the total in line 15.

After manually subtracting this amount, if the budget unit that had income deemed FROM has excess income, all persons in that budget unit would fail Family Coverage eligibility. Also, everyone in the deemed TO Budget Unit(s) would fail, if their parent or spouse in the deemed FROM Budget Unit had the excess income.

Case Example #1: Ongoing case consists of Mother, Husband and Mothers' child (Single Stepparent Case). Mother has $600 gross earned income and Husband has $1200 gross income. This case will have two budget units. Budget Unit #1 would be Mother and Father, and Budget Unit #2 would be for Mothers' child.

Step #1: Compute a Spreadsheet for each Budget unit.

Step #2: The Family Coverage Income Level for Budget Unit #1 is $387.00. Husband's income is sufficient to meet all of the needs of Budget Unit #1. Since Budget Unit #2 has unmet needs of $286, Mother can deem all of her net income ($210.00) to her child. Subtract $210.00 from line #15 ($648.00) which results in $438.00 countable income. Since Budget Unit #1 still has excess income, Mother is not eligible for Family Coverage. Since none of the excess income in Budget Unit #1 is Mothers' because all of Mothers' excess income was deemed to her child, Budget Unit #2 (Mothers' child) is Family Coverage eligible.

Case Example #2: Same case make-up , but Mother has $1300 gross earned income and Husband has $600 in earned income. This case will have two budget units. Budget Unit #1 would be Mother and Father, and Budget Unit #2 would be for Mothers' child.

Step #1: Compute a Spreadsheet for each Budget unit.

Step #2: The Family Coverage Income Level for Budget Unit #1 is $387.00. Husband can meet $210.00 of the needs for Budget Unit #1 and Mother meets the remaining $177.00. After deducting the $177.00 from Mothers' income, $297.50 remains of which $286.00 can be deemed to her child. Mother still has excess income of $11.50. Since Mothers' has the excess income, both Budget Unit #1 and Budget Unit #2 fail Family Coverage.

If you have any additional questions, please contact your Regional Rep.