Section 405IAC10-4-5. Transitional medical assistance category

   (a) The transitional medical assistance category under the plan is available only to those members listed in section 4(c) of this rule.

  (b) The transitional medical assistance category under the plan provides guaranteed HIP State Plan coverage for six (6) months. The coverage may last up to twelve (12) months as provided in this section.

  (c) A member in the transitional medical assistance category and enrolled in HIP State Plan Plus shall make the POWER account contributions in accordance with 405 IAC 10-10-3(a). A member who fails to make the member's POWER account contributions, regardless of household income, shall be transferred to HIP State Plan Basic and shall be responsible for paying the copayments at the time of service delivery in accordance with 405 IAC 10-10-3(b).

  (d) A member who is eligible for the transitional medical assistance category shall complete and return a report on a form sent by the division at month three (3), six (6), and nine (9) of the potential twelve (12) month period in order to maintain eligibility for the transitional medical assistance category under the plan.

  (e) A member who fails to submit the required report as set forth in subsection (d) to the division at month three (3) or six (6) shall no longer be eligible for the transitional medical assistance category and shall be terminated from the plan at month six (6). A member who fails to submit the required report as set forth in subsection (d) to the division at month nine (9) shall no longer be eligible for the transitional medical assistance category and shall be terminated from the plan at the end of month nine (9). A member who is terminated from the plan based upon the member's failure to submit a required report to the division may reapply to the plan at any time.

  (f) A member shall be ineligible to receive coverage under this section at the end of the transitional medical assistance coverage period. (Office of the Secretary of Family and Social Services; 405 IAC 10-4-5; filed May 18, 2015, 12:34 p.m.: 20150617-IR-405140339FRA)