Section 405IAC10-4-4. Section 1931 parents and caretaker relatives; low income dependent  


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  •    (a) An eligible applicant or member who meets the definition for Section 1931 parent and caretaker relative or low income dependent shall be enrolled in either HIP State Plan Plus or HIP State Plan Basic in accordance with 405 IAC 10-3-2 or 405 IAC 10-3-3, as applicable.

      (b) If a member under this section is determined to no longer meet the Section 1931 parent and caretaker relative definition based upon reasons other than those listed in subsection (c), but is still eligible under the plan, the member shall be transferred to:

    (1) HIP Plus if the member is currently enrolled in HIP State Plan Plus; or

    (2) HIP Basic if the member is currently enrolled in HIP State Plan Basic.

      (c) A member who no longer meets the Section 1931 parent and caretaker relative definition because of increased income from employment that results in household income greater than allowed under Section 1931 of the Social Security Act shall be eligible to receive transitional medical assistance in accordance with section 5 of this rule.

      (d) A member who meets the Section 1931 parent and caretaker relative definition and is at least sixty-five (65) years of age while enrolled in the plan shall remain eligible for the plan for so long as the member continues to meet the Section 1931 parent and caretaker relative definition under 405 IAC 10-2-1(46).

      (e) A member who meets the Section 1931 parent and caretaker relative definition and who:

    (1) has not received Medicaid coverage or coverage under the plan within two (2) years of the date in which the member began receiving HIP State Plan benefits under this section; or

    (2) is newly enrolled in the plan and meets one (1) of the exceptions described in 405 IAC 10-10-13;

    shall be eligible for additional coverage as set forth in 405 IAC 10-9-5(b). (Office of the Secretary of Family and Social Services; 405 IAC 10-4-4; filed May 18, 2015, 12:34 p.m.: 20150617-IR-405140339FRA)