405 IAC 2-9-1 - Purpose and general eligibility requirements
Authority: IC 12-15
Affected: IC 12-15-41
Sec. 1.
(a) This
rule establishes the eligibility requirements for the two (2) optional Medicaid
categories for employees with disabilities identified in
42 U.S.C.
1396a(a)(10)(A)(ii)(XV) and
42 U.S.C. 1396a(a)(10)(A)(ii)(XVI), and in accordance with the provisions of IC
12-15-41.
(b) As used in this rule,
"applicant or member" means an individual whose Medicaid eligibility is being
determined under one (1) of the Medicaid categories referenced in subsection
(a) and in accordance with the requirements of this rule.
(c) A person who is:
(1) less than sixteen (16) years of age;
or
(2) sixty-five (65) years of age
or older;
is not eligible for Medicaid for employees with disabilities.
(d) A member must report any change in
income, resources, employment status, or marital status within ten (10) days of
the date of the change. An additional ten (10) days is allowed to provide any
necessary verification.
(e) A
disabled individual will be considered for eligibility under this rule if the
individual is ineligible for Medicaid under the disability category for any of
the following reasons:
(1) The individual's
income exceeds the applicable standard specified in
405 IAC 2-1.1-5.
(2) The individual's resources exceed the
limit in
20 CFR
416.1205.
(3) The individual's gross earnings exceed
the substantial gainful activity amount established by the Social Security
Administration in
20 CFR
416.974.
(f) In addition to the requirements in this
rule, the requirements in the following apply to applicants and members of
Medicaid for employees with disabilities:
(1)
405 IAC 2-1-2.
(2)
405 IAC 2-1-3.
(3)
405 IAC 2-2-4.
(4)
405 IAC 2-3-1.1.
(5)
405 IAC 2-3-2.
(6)
405 IAC 2-3-12.
(7)
405 IAC 2-3-14.
(8)
405 IAC 2-3-22.
(9)
405 IAC 2-4-1.
(10)
405 IAC 2-5-1.
(11)
405 IAC 2-8-1.
(12)
405 IAC 2-8-2.
Notes
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