405 IAC 2-1-1 - Definitions

Authority: IC 12-13-5-3; IC 12-13-7-3; IC 12-15-1-10

Affected: IC 12-15-4; IC 12-15-5

Sec. 1.

The following definitions in this section apply throughout this article:

(1) "Applicant" means a person for whom Medicaid is requested.

(2) "Community spouse" has the meaning set forth in 42 U.S.C. 1396r-5(h)(2).

(3) "Dependent child" means a nonmember child either:

(A) less than eighteen (18) years of age; or

(B) between eighteen (18) and twenty-one (21) years of age and a student regularly attending a school, college, or university, or a course of vocational or technical training designed to prepare them for gainful employment.

A dependent child must be the biological or adoptive child of an applicant or a member, or the biological or adoptive child of an applicant's or a member's parent.

(4) "Essential person" means a person who:

(A) is not an applicant's or a member's spouse or parent;

(B) lives in the place of residence of an applicant or a member; and

(C) is considered by an applicant or a member to be essential to their well-being because the person provides services to the applicant or member that would have to be paid for otherwise.

(5) "Ineligible spouse" has the meaning set forth in 20 CFR 416.1160(d).

(6) "Institution" means a Title XIX certified hospital, a nursing facility, an intermediate care facility for individuals with intellectual disabilities, or a public institution. The term does not include a facility where federal financial participation is not available under 42 CFR 435.1009.

(7) "Institutionalized spouse" has the meaning set forth in 42 U.S.C. 1396r-5(h)(1).

(8) "Medicaid" means that program described by IC 12-15 and this title, in which the office administers benefits and pays providers for covered services provided to members.

(9) "Member" means an individual determined by the office to be eligible for payment of covered services under IC 12-15 or this title, or both.

(10) "Nonmember" means a person not receiving Medicaid.

(11) "Office" means the Indiana family and social services administration, and its offices, divisions, or designees.

(12) "Parent" or "parents" means the biological or adoptive parent or parents living with an unmarried applicant or member either:

(A) less than eighteen (18) years of age; or

(B) between eighteen (18) and twenty-one (21) years of age and a student regularly attending a school, college, or university, or a course of vocational or technical training designed to prepare them for gainful employment.

(13) "Retirement account" means any of the following:

(A) An individual retirement account established by an employee or employer.

(B) An annuity described in Section 408 of the Internal Revenue Code.

(C) A Keogh plan.

(D) A 401(k).

(E) A 403(b).

(F) A defined benefit plan.

(G) An account similar to those listed in clauses (A) through (F).

(14) "Spouse" means the legal husband or wife of an applicant or a member either living with the applicant or member or physically separated from them only for medical reasons.

Notes

405 IAC 2-1-1

Office of the Secretary of Family and Social Services; 405 IAC 2-1-1; filed Mar 1, 1984, 2:31 p.m.: 7 IR 1012, eff Apr 1, 1984; filed Jun 19, 1984, 10:25 a.m.: 7 IR 1820, eff Jul 1, 1984 [IC 4-22-2-5 suspends the effectiveness of a rule document for thirty (30) days after filing with the secretary of state. LSA Document #84-29 was filed Jun 19, 1984.]; filed Apr 10, 1985, 2:20 p.m.: 8 IR 989; filed Apr 4, 1986, 11:07 a.m.: 9 IR 1854; filed Aug 15, 1986, 3:00 p.m.: 10 IR 6; filed May 11, 1987, 9:30 a.m.: 10 IR 1864; filed Apr 26, 1988, 12:55 p.m.: 11 IR 3028; filed Oct 6, 1989, 4:50 p.m.: 13 IR 282; filed May 2, 1990, 4:55 p.m.: 13 IR 1704; filed Aug 9, 1991, 11:00 a.m.: 14 IR 2224; filed May 14, 1992, 5:00 p.m.: 15 IR 2189; filed Feb 16, 1993, 5:00 p.m.: 16 IR 1780; filed Nov 26, 1996, 4:30 p.m.: 20 IR 955; readopted filed Jun 27, 2001, 9:40 a.m.: 24 IR 3822; readopted filed Sep 19, 2007, 12:16 p.m.: 20071010-IR-405070311RFA; readopted filed Oct 28, 2013, 3:18 p.m.: 20131127-IR-405130241RFA; 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 Filed 6/26/2024, 10:03 a.m.: 20240724-IR-405230819FRA

Transferred from the Division of Family and Children (470 IAC 9.1-1-1) to the Office of the Secretary of Family and Social Services (405 IAC 2-1-1) by P.L.9-1991, SECTION 131, effective January 1, 1992.