405 IAC 10-4-1 - Eligibility requirements

Authority: IC 12-15-44.5-9

Affected: IC 12-15-44.5; IC 12-17.6; IC 27-8-14.1-1

Sec. 1.

(a) The following individual shall be eligible for participation in the plan if the individual:

(1) Is at least nineteen (19) years of age and less than sixty-five (65) years of age, except as set forth in section 4(d) of this rule.

(2) Is an Indiana resident.

(3) Is not enrolled in or eligible for enrollment in the federal Medicare program.

(4) Is not eligible for another Medicaid assistance category, except for the following:

(A) Section 1931 parents and caretaker relatives.

(B) Transitional medical assistance.

(C) Members eligible for the HIP Maternity category in accordance with section 6 of this rule.

(5) Has household income at or below one hundred thirty-three percent (133%) of the FPL for the applicable family size.

(b) As a condition of eligibility, an individual living with a dependent child less than nineteen (19) years of age shall ensure that the child is enrolled in Medicaid, the Children's Health Insurance Program under IC 12-17.6, or otherwise receiving minimum essential coverage as defined in 26 U.S.C. 5000A(f). This condition does not apply to the following:

(1) Section 1931 parents and caretaker relatives.

(2) Transitional medical assistance.

(3) Pregnant women.

(c) There shall not be an asset or resource test for the plan.

(d) As a condition of eligibility for the receipt of benefits, a member may be required to participate in the Gateway to Work community engagement program pursuant to 405 IAC 10-12.

Notes

405 IAC 10-4-1

Filed 5/18/2015, 12:34 p.m.: 20150617-IR-405140339FRA Filed 1/19/2018, 8:42 a.m.: 20180214-IR-405170484FRA Filed 3/18/2019, 2:27 p.m.: 20190417-IR-405180371FRA