Section 405IAC10-4-10. Loss of eligibility

   (a) During the twelve (12) month coverage period, an individual shall become ineligible to participate in the plan under the following circumstances:

(1) The member is no longer an Indiana resident.

(2) The member is enrolled or is otherwise eligible for enrollment in the federal Medicare program.

(3) The member becomes eligible for another Medicaid assistance category, except for:

(A) Section 1931 parents and caretaker relatives;

(B) low income dependents;

(C) transitional medical assistance; or

(D) pregnant women Medicaid category.

(4) The member has household income above one hundred percent (100%) of the FPL and is terminated under 405 IAC 10-10-12 for failure to make the required POWER account contributions, unless the member is excepted under 405 IAC 10-10-13.

(5) The member or the member's duly authorized representative requests in writing that coverage be terminated.

(6) The member falsifies information on the application.

(7) The member is at least sixty-five (65) years of age unless the member is:

(A) a Section 1931 parent and caretaker relative; or

(B) eligible for transitional medical assistance.

(8) Except for a member eligible for transitional medical assistance, the member's household income exceeds one hundred thirty-three percent (133%) of the FPL.

  (b) Coverage shall be terminated for a member who loses eligibility under this section. (Office of the Secretary of Family and Social Services; 405 IAC 10-4-10; filed May 18, 2015, 12:34 p.m.: 20150617-IR-405140339FRA)