Form Mc 176 W.1 - Stepparent Computation When Only The Separate Children Of One Spouse Want Medi-Cal Page 2
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4II. PROPERTY DETERMINATION
A. Allocation from Natural/Adoptive Parent
Consider only the natural/adoptive parent’s separate and one-half community property; enter the total amount under
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Column II.
If property is owned by more than one person, equally divide the net market value by the number of owners unless
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evidence is provided to rebut the division.
Joint bank accounts: If available to the MFBU, do not count the money in a joint account against the MFBU more
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than once. Equally divide the bank account by the number of owners in the MFBU (subject to rebuttal).
List Only the Parent’s Nonexempt Property
Value
1. Excess other real property
2. Checking
3. Savings
4. Life insurance (CSV)
5. Cash
6. Nonexempt vehicle
7. Other
8.
9.
10.
11. Total net nonexempt property
12. Number of persons for whom parent is responsible
(enter total from section I.D.)
13. Allocation to each person for whom parent is
responsible (divide line 11 by line 12)
B. Net Nonexempt Property of Children in MFBU
Enter Name of Each Child in the MFBU
1.
2.
3.
14. Checking
15. Savings
$
$
$
16. Nonexempt vehicle
17. Nonexempt ORP
18. Other
19.
20.
21. TOTAL
22. Allocation from parent (enter amount from
line 13 in each child’s box)
23. Subtotal net nonexempt property for MFBU (add
lines 21 and 22)
24. Total net nonexempt property for MFBU (add
all the subtotals from lines 13 and 23)
25. Enter property limit for MFBU
26. Excess property
If ineligible due to excess property and the separate child(ren) who want Medi-Cal has own nonexempt property, Sneede case exists.
Complete MC 175-4 next. Establish a single mini budget unit for the parent and his/her separate children who have no (or only exempt)
property of his/her own. Establish a separate mini budget unit for each child with own nonexempt property. Enter amount from line 13 as
parent’s net nonexempt property on MC 175 S-4. Enter amount from line 23 as child’s net nonexempt property on MC 175 S-4.
If property eligible, continue.
Page 2 of 4
MC 176 W.1 (05/07)
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