Ohio Admin. Code 5160:1-3-03.5 - Medicaid: application of income standards
(A) The purpose of this rule is to set forth
the application of income standards used in medicaid eligibility determinations
of medical assistance for aged, blind, or
disabled individuals.
(B)
Definitions.
(1) "Income standard" means the
income limit above which an individual is ineligible for a given category of
medicaid
medical
assistance for the aged, blind, or
disabled.
(2) "Couple income
standard" is equal to the current supplemental security income (SSI) benefit
rate for a couple. The updated figure is published annually by the social
security administration.
(3)
"Individual income standard" is equal to the current supplemental security
income (SSI) benefit rate for an individual. The updated figure is published
annually by the social security administration.
(C) Application of income standards.
(1) For an individual, countable income is
compared to the appropriate individual income standard.
(2) For a married couple:
(a)
If
When both members
of the married couple are categorically eligible, countable income is compared
to the appropriate couple income standard.
(b)
If
When only one
member of the married couple is categorically eligible, countable income may be
compared to either the individual income standard or the couple income
standard, in accordance with the deeming provisions set forth in rule
5160:1-3-03.3 of the
Administrative Code.
Notes
Promulgated Under: 111.15
Statutory Authority: 5160.02, 5163.02
Rule Amplifies: 5160.02, 5163.02
Prior Effective Dates: 09/03/1977, 12/31/1977, 03/01/1979, 10/01/1979, 12/07/1979, 01/03/1980, 07/01/1980, 08/01/1981, 07/01/1982, 12/01/1982, 07/01/1983 (Temp.), 09/24/1983, 01/01/1985 (Emer.), 04/01/1985, 05/01/1985 (Emer.), 07/31/1985, 01/01/1986 (Emer.), 04/01/1986, 01/01/1987 (Emer.), 03/20/1987, 01/01/1988 (Emer.), 02/01/1988 (Emer.), 03/21/1988, 01/01/1989 (Emer.), 04/01/1989, 05/01/1989 (Emer.), 07/08/1989, 01/01/1990 (Emer.), 04/01/1990, 04/02/1990 (Emer.), 06/22/1990, 01/01/1991 (Emer.), 04/01/1991, 04/02/1991 (Emer.), 06/17/1991, 01/01/1992 (Emer.), 03/20/1992, 04/01/1992 (Emer.), 06/30/1992, 01/01/1993 (Emer.), 03/18/1993, 03/25/1993, 06/11/1993, 09/01/1993, 03/18/1994, 02/01/1995, 04/01/1995 (Emer.), 06/11/1995, 04/01/1996, 01/01/1997 (Emer.), 02/09/1997, 12/03/1997 (Emer.), 02/01/1998, 01/08/1999 (Emer.), 04/01/1999, 01/01/2000 (Emer.), 04/01/2001, 06/02/2001, 05/12/2002, 01/25/2015, 07/01/2016, 03/01/2017
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
(A) The purpose of this rule is to set forth the application of income standards used in medicaid eligibility determinations for aged, blind, or disabled individuals.
(B) Definitions.
(1) "Income standard" means the income limit above which an individual is ineligible for a given category of medicaid for the aged, blind or disabled.
(2) "Couple income standard" is equal to the current supplemental security income (SSI) benefit rate for a couple. The updated figure is published annually by the social security administration.
(3) "Individual income standard" is equal to the current supplemental security income (SSI) benefit rate for an individual. The updated figure is published annually by the social security administration.
(4) The "special income level" for institutionalized individuals is equal to three hundred percent of the current supplemental security income (SSI) benefit payment rate for an individual.
(C) Application of income standards.
(1) For an individual, countable income is compared to the appropriate individual income standard. An institutionalized individual, even if married, is treated as an individual.
(2) For a married couple:
(a) If both members of the married couple are categorically eligible, countable income is compared to the appropriate couple income standard.
(b) If only one member of the married couple is categorically eligible, countable income may be compared to either the individual income standard or the couple income standard, in accordance with the deeming provisions set forth in rule 5160:1-3- 03.9 5160:1-3- 03.3 of the Administrative Code.
Notes
Promulgated Under: 111.15
Statutory Authority: 5160.02, 5163.02
Rule Amplifies: 5160.02, 5163.02
Prior Effective Dates: 9/3/77, 12/31/77, 3/1/79, 10/1/79, 12/7/79, 1/3/80, 7/1/80, 8/1/81, 7/1/82, 12/1/82, 7/1/83 (Temp.), 9/24/83, 1/1/85 (Emer.), 4/1/85, 5/1/85 (Emer.), 7/31/85, 1/1/86 (Emer.), 4/1/86, 1/1/87 (Emer.), 3/20/87, 1/1/88 (Emer.), 2/1/88 (Emer.), 3/21/88, 1/1/89 (Emer.), 4/1/89, 5/1/89 (Emer.), 7/8/89, 1/1/90 (Emer.), 4/1/90, 4/2/90 (Emer.), 6/22/90, 1/1/91 (Emer.), 4/1/91, 4/2/91 (Emer.), 6/17/91, 1/1/92 (Emer.), 3/20/92, 4/1/92 (Emer.), 6/30/92, 1/1/93 (Emer.), 3/18/93, 3/25/93, 6/11/93, 9/1/93, 3/18/94, 2/1/95, 4/01/95 (Emer.), 6/11/95, 4/1/96, 1/1/97 (Emer.), 2/9/97, 12/3/97 (Emer.), 2/1/98, 1/8/99 (Emer.), 4/1/99, 1/1/00 (Emer), 4/1/01, 6/2/01, 5/12/02, 1/25/15, 7/1/16