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

405 IAC 10-4-5

Filed 5/18/2015, 12:34 p.m.: 20150617-IR-405140339FRA Filed 1/19/2018, 8:42 a.m.: 20180214-IR-405170484FRA Errata Filed 2/22/2018, 9:36 a.m: 20180307-IR-405180114ACA