R Marital Status

Revised 07/10/2020

Policy

When a customer marries or divorces, it may affect the customer’s eligibility or the amount the customer must pay for a Share of Cost (SOC), premium or copayments.

When the customer divorces, the change in status is effective the month following the month the divorce is final.

When a customer marries, the change in status is effective the month the marriage took place.

For policy on a change in marital status due to the death of a spouse, see MA1502G.

For policy on physical separation of spouses, see MA1502Z.

The following table describes how changes in marital status may affect different programs:

When the program is...	Then...
ALTCS	The change may affect whether or not: Community Spouse policy applies; The spouse’s income is included in the income determination; The spouse’s resources are included in the resource determination; and The spouse’s income and expenses are included in the SOC determination.
Freedom to Work (FTW)-ALTCS	The change may affect whether or not Community Spouse policy applies when determining the customer’s SOC.
FTW Breast and Cervical Cancer Treatment Program (BCCTP)	The customer may qualify for another Medicaid program because of the different income budgeting for married couples.
SSI-MAO Medicare Savings Program (MSP)	The change may affect whether or not: The spouse’s income is included in the income determination; and The couple income standard may be used instead of the individual standard.
Adult Caretaker Relative Pregnant Woman; Child; or KidsCare	The change may affect who is included in the customer’s income group. See MA602D.

See Processing Changes in Marital Status for instructions.

Definitions

Term	Definition
Change in marital status	A customer marries or divorces, or is widowed.

Proof

For all programs except ALTCS and Freedom to Work (FTW), a person’s statement of marriage is accepted as proof unless there is evidence to the contrary. A customer’s marital status is not needed for FTW eligibility. For ALTCS, see the chart below. The proof needed is based on the marital relationship claimed.

Type	Proof
Legal Marriage	An official marriage license; Court or church records; Marital Status and Family Profile Document issued by the Navajo Nation; Tribal Family Census Card issued by the Bureau of Indian Affairs; Marriage license issued by the Navajo Office of Vital Records; or Phone contacts with an official Agency or Court. NOTE Social Security (SSA) or SSI benefit records cannot be used for proof of legal marriage.
Common Law Marriage established outside Arizona	A completed Customer Statement – Common Law Marriage (DE-119) form. When you receive a DE-119 form, submit a Policy Clarification Request (PCR) through PATS. The Office of Eligibility Policy (OEP) will review the form and determine whether the marriage meets legal requirements.
Divorced	Accept the person’s statement unless it is questionable. For example, when a customer previously claimed to be married but later claims to be divorced or widowed, ask for proof of the divorce or death.

Programs Affected

This applies to all programs.

Timeframes

Changes must be reported as soon as the future event becomes known. Unanticipated changes must be reported within 10 calendar days of the date the change occurred.

Legal Authority

Program	Legal Authorities
ALTCS	42 USC 1396r-5 for Community Spouse 42 CFR 435.916 AAC R9-28-411(A)(1)(h)
SSI-MAO	20 CFR 416.432, 435, 1132, and 1163 42 CFR 435.602 42 CFR 435.916 AC R9-22-1501(H)(1)(e) AAC R9-22-1503, 1504 and 1505
Medicare Savings Program (MSP)	20 CFR 416.432, 435, 1132, and 1163 42 CFR 435.602 42 CFR 435.916 AAC R9-29-213
Freedom to Work (FTW)	42 CFR 435.916 AAC R9-22-1901
Breast and Cervical Cancer Treatment Program (BCCTP)	42 CFR 435.916 AAC R9-22-2008
Adult Caretaker Relative Pregnant Woman Child	42 CFR 435.603 42 CFR 435.916
KidsCare	42 CFR 457.343