Ohio Admin. Code 5160:1-4-03 - [Effective until1/1/2023]MAGI-based medicaid: coverage for Ribicoff and former foster care children
(A) This rule describes
medicaid
the
eligibility criteria for applications for medical assistance for individuals:
(1) Who are age nineteen or twenty years of age ;
,
or
(2) Who aged out of foster care
on their eighteenth birthday, are younger
than age twenty-six years of age , and are not otherwise eligible under
rule
5160:1-4-02
of the Administrative Code
for a mandatory
category of coverage under the medicaid state plan. An individual who is
eligible for coverage both as a former foster care child and under the coverage
described in section 1902(a)(10)(A)(i) (VIII) of the Social Security Act (as in
effect October 1, 2020) shall be placed in the former foster care eligibility
category .
(B)
Eligibility criteria for coverage because an individual is
age nineteen or twenty
years of age in accordance with
42
C.F.R. 435.222 (as in effect
July 1, 2014
October
1, 2020 ).
(1) The individual must be
age nineteen or twenty
years of age .
(2) The individual's family size and
household income must be calculated as described in rule
5160:1-4-01
of the Administrative Code.
(3) The
individual's household income must not exceed fourty-four per cent of the
federal poverty level for the family size.
(C) Eligibility criteria for coverage because
an individual aged out of foster care in accordance with
section 1902(a)(10)(A)(i)(IX) of the Social Security
Act
42 C.F.R.
435.150
(as in effect
July 1, 2014
October
1, 2020 ).
(1) The individual must:
(a) Be at least eighteen years
old
of age and
younger than twenty-six years old
of age ;
(b) Have been in foster care under the
responsibility of the state of Ohio on the
individual's eighteenth birthday, or at the time of
aging out of the state's foster care program ;
(c) Have been eligible for and enrolled in
medicaid while in such foster care; and
(d) Cooperate in establishing eligibility,
which includes signing and dating the application.
(2) Under this paragraph, there is no income
test for coverage because an individual aged out of foster care.
Notes
Promulgated Under: 111.15
Statutory Authority: 5160.02, 5162.03, 5163.02
Rule Amplifies: 5160.02, 5162.03, 5163.02
Prior Effective Dates: 10/01/2013, 03/26/2015, 01/01/2016
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) This rule describes medicaid the eligibility criteria for applications for medical assistance for individuals:
(1) Who are age nineteen or twenty years of age ; , or
(2) Who aged out of foster care on their eighteenth birthday, are younger than age twenty-six years of age , and are not otherwise eligible under rule 5160:1-4-02 of the Administrative Code for a mandatory category of coverage under the medicaid state plan. An individual who is eligible for coverage both as a former foster care child and under the coverage described in section 1902(a)(10)(A)(i) (VIII) of the Social Security Act (as in effect October 1, 2020) shall be placed in the former foster care eligibility category .
(B) Eligibility criteria for coverage because an individual is age nineteen or twenty years of age in accordance with 42 C.F.R. 435.222 (as in effect July 1, 2014 October 1, 2020 ).
(1) The individual must be age nineteen or twenty years of age .
(2) The individual's family size and household income must be calculated as described in rule 5160:1-4-01 of the Administrative Code.
(3) The individual's household income must not exceed fourty-four per cent of the federal poverty level for the family size.
(C) Eligibility criteria for coverage because an individual aged out of foster care in accordance with section 1902(a)(10)(A)(i)(IX) of the Social Security Act 42 C.F.R. 435.150 (as in effect July 1, 2014 October 1, 2020 ).
(1) The individual must:
(a) Be at least eighteen years old of age and younger than twenty-six years old of age ;
(b) Have been in foster care under the responsibility of the state of Ohio on the individual's eighteenth birthday, or at the time of aging out of the state's foster care program ;
(c) Have been eligible for and enrolled in medicaid while in such foster care; and
(d) Cooperate in establishing eligibility, which includes signing and dating the application.
(2) Under this paragraph, there is no income test for coverage because an individual aged out of foster care.
Notes
Promulgated Under: 111.15
Statutory Authority: 5160.02, 5162.03, 5163.02
Rule Amplifies: 5160.02, 5162.03, 5163.02
Prior Effective Dates: 10/01/2013, 03/26/2015, 01/01/2016