Sixth Circuit Court Weighs in on the Definition of Family
September 14, 2015|
When Joe Turner applied for Medicare benefits, he was denied. The Ohio Department of Medicaid said that he didn’t qualify because he belonged to a family of one. But Joe is married and meets the income eligibility. Turner is one of three plaintiffs in a federal class action suit that Pro Seniors filed, challenging the way that the State of Ohio defines the word “family” when determining eligibility for certain health care benefits. Today, the Sixth Circuit Court of Appeals ruled that “family” does include the Medicare beneficiary’s spouse.
The Medicaid Act requires states that receive federal Medicaid funds to provide low-income Medicare beneficiaries with financial assistance to help pay their out-of-pocket Medicare costs. In determining eligibility for the assistance, Ohio refused to treat a Medicare beneficiary’s spouse as a member of his or her “family.”
The Sixth Circuit Court of Appeals’ ruling reverses a federal district court ruling. The Ohio Department of Medicaid has the option of asking for reconsideration by the entire Sixth Circuit or appealing to the U.S. Supreme Court.