405 IAC 10-4-5 - Transitional medical assistance category
Authority: IC 12-15-44.5-9
Affected: IC 12-15-44.5
Sec. 5.
(a) The
transitional medical assistance category under the plan is available only to
those members listed in section 4(c) of this rule.
(b) The transitional medical assistance
category under the plan provides for continued HIP eligibility for Section 1931
parent and caretaker relatives whose income from employment increases to above
one hundred thirty-three percent (133%) of the FPL. If all other requirements
of the program are met, these members may receive HIP coverage for an
additional six (6) months regardless of the amount of increased income. If the
increase does not equal more than one hundred eighty-five percent (185%) of the
FPL, the coverage may last up to twelve (12) months as provided in this
section. Actual childcare expenses due to employment shall be deducted from
countable income during the transitional medical assistance period.
(c) A member in the transitional medical
assistance category shall make the POWER account contributions in accordance
with
405 IAC
10-10-3(a). A member who fails to
make the member's POWER account contributions, regardless of household income,
shall lose eligibility under transitional medical assistance, and if income has
not decreased to below one hundred percent (100%) of the FPL, shall lose
eligibility for the plan altogether.
(d) A member who is eligible for the
transitional medical assistance category shall respond to requests to resolve
discrepant information, and must comply with annual redetermination if it comes
due during the transitional medical assistance period in order to maintain
eligibility for such assistance category under the plan, but there shall not be
any additional reporting required from these members.
(e) A member who no longer meets the
parent/caretaker requirement due to having no remaining dependents in the home,
or who does not maintain employment and shows no good cause for the job loss,
shall no longer be eligible for the transitional medical assistance category.
If the member is not eligible without the protection of the transitional
medical assistance category, the member shall be terminated from the plan. A
member whose income increases to over one hundred eighty-five percent (185%) of
the FPL shall no longer be eligible for the transitional medical assistance
category and shall be terminated from the plan at the end of month six (6) or
at the time of the increase, whichever is later. Members terminated for reasons
other than nonpayment of required POWER account may reapply to the plan at any
time.
(f) A member shall be
ineligible to receive coverage under this section at the end of the
transitional medical assistance coverage period and shall be terminated from
the plan altogether if countable household income remains in excess of one
hundred and thirty-three percent (133%) of the FPL at the expiration of the
maximum twelve (12) months of transitional medical assistance.
Notes
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