405 IAC 2-1.1-1 - Definitions

Authority: IC 12-15

Affected: IC 12-15-2; IC 12-15-3

Sec. 1.

(a) The definitions in this section apply throughout this rule.

(b) "Applicant" means an individual applying for Medicaid eligibility on the basis of blindness or disability.

(c) "Change in circumstances" means any of the following:

(1) A disabling condition different from, or in addition to, that considered by SSA in making a previous SSA determination.

(2) That more than twelve (12) months after the most recent SSA determination denying disability, an individual's condition has changed or deteriorated resulting in a new period of disability, and such individual has not applied to SSA for a determination with respect to these new allegations.

(3) That less than twelve (12) months after the most recent SSA determination denying disability, an individual's condition has changed or deteriorated, alleging a new period of disability and either the individual:

(A) has applied to SSA for reconsideration or reopening of its disability decision and SSA refused to consider the new allegations; or

(B) no longer meets the nondisability requirements for SSI but may meet the state's nondisability requirements for Medicaid eligibility.

(d) "FPL" refers to the federal poverty level.

(e) "MAGI" refers to the methodology for how income is counted and how household composition and family size are determined as set forth in 42 CFR 435.603.

(f) "Member" means the individual receiving benefits due to age, disability, or blindness.

(g) "Special income level" refers to an amount equal to three hundred percent (300%) of the maximum benefit payable under the SSI program.

(h) "SSA" refers to the federal Social Security Administration.

(i) "SSA determination" means a final agency action by which SSA has determined an individual's eligibility or ineligibility for SSI.

(j) "SSDI" means Social Security disability insurance benefits provided through SSA.

(k) "SSI" means supplemental security income provided through SSA.

(l) "State" includes the office.

Notes

405 IAC 2-1.1-1

Office of the Secretary of Family and Social Services; 405 IAC 2-1.1-1; filed Apr 8, 2014, 12:37 p.m.: 20140507-IR-405130533FRA Readopted filed 11/13/2019, 11:54 a.m.: 20191211-IR-405190487RFA Filed 6/11/2021, 2:35 p.m.: 20210707-IR-405190602FRA