B How to Determine Indigency

Program	Manual Section
All programs	MA608.B

Review the AH-611 form completed by the customer. Follow the steps below to determine if the customer is exempt from sponsor deeming:

Step	Action
1	Is the customer living with his or her sponsor? If YES, STOP. The customer is NOT indigent. If NO, continue to Step 2.
2	Does the customer receive free room and board? If YES, STOP. The customer is NOT indigent. If NO, continue to Step 3.
3	Use the Indigent Exception Worksheet to determine the total gross income of the noncitizen’ family. AHCCCS Staff: Use form AH-402 DES Staff: Use form FAA-1544A
4	Compare the total gross income from the Indigent Exception Worksheet to 100% FPL for the family size (MA615). Is the total gross income more than 100% FPL? If YES, STOP. The customer is NOT indigent. If NO, the customer is considered indigent. Continue to Step 5.
5	Do not deem income or resources from the sponsor for 12 months beginning with the application month. Document the indigent exemption and the 12-month period in the case notes.
6	For each month in which the sponsor gives the customer money, enter the amount of money given to the customer using the “Gift” income type in HEAplus.
7	Complete the Notice of Indigent Exception form. Mail the completed form to the Department of Homeland Security at the address printed on the form. AHCCCS Staff: Use form AH-706 DES Staff: Use form FAA-1545A