reglab/statecodes huggingface dataset:
Indiana Administrative Code › Title 405 - OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES › Article 5 - MEDICAID SERVICES › Rule 34 - Hospice Services › Section 34-12 - Reservation of beds for hospice members in nursing facilities

Current through July 10, 2024
Authority: IC
				  12-15-1-10; IC
				  12-15-21-2; IC
				  12-15-40
Affected: IC 12-15
Sec. 12.
(a) Although
				it is not mandatory for providers to reserve beds, Medicaid will reimburse for
				reserving nursing facility beds for hospice members at one-half (1/2) the room
				and board payment provided that the criteria as set out in this section are
				met.
(b) Hospitalization must be
				ordered by the hospice physician for treatment of an acute condition that
				cannot be treated in the nursing facility by the hospice provider. The maximum
				length of time allowed for payment of a reserved bed for a single hospital stay
				is fifteen (15) days.
(c) A leave
				of absence must be for therapeutic reasons, as prescribed by the hospice
				attending physician and as indicated in the hospice member's plan of care. The
				maximum length of time allotted for therapeutic leave in any calendar year is
				limited to eighteen (18) days, which need not be consecutive.
(d) Although prior authorization by the
				office is not required to reserve a bed, the hospice member's physician's order
				for the hospitalization or therapeutic leave must be on file in the nursing
				facility.
(e) In no instance will
				Medicaid reimburse a nursing facility for reserving nursing facility beds for
				hospice members when the nursing facility has an occupancy rate of less than
				ninety percent (90%). For purposes of this rule, the occupancy rate shall be
				determined by dividing the total number of residents in licensed beds,
				excluding residential beds, in the nursing facility taken from the midnight
				census as of the day that a Medicaid hospice member takes a leave of absence,
				by the total number of licensed nursing facility beds, excluding residential
				beds.
Indiana Administrative Code › Title 405 - OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES › Article 5 - MEDICAID SERVICES › Rule 35 - Case Management Services for Infants and Toddlers with Disabilities › Section 35-1 - Definitions

Current through July 10, 2024
Authority: IC
				  12-15-1-10; IC
				  12-15-21-2; IC
				  12-15-21-3
Affected: IC 12-15
Sec. 1.
(a) The
				definitions in this section apply throughout this rule.
(b) "IFSP" means the individualized family
				service plan, a written plan for providing early intervention services to a
				child eligible for early intervention services and the child's
				family.
(c) "Service coordination
				services" means targeted case management services. Providers of targeted case
				management services are referred to as "service coordinators" in this
				rule.
(d) "Targeted case management
				services for infants and toddlers with disabilities" means an active, ongoing
				process of assisting the infant or toddler and his or her family to identify,
				access, and utilize early intervention services to benefit the development of
				the child and to coordinate the services to meet the individual needs of the
				infant or toddler and his or her family. The term includes the following
				services:
(1) Coordinating the evaluation
				activities related to eligibility redetermination.
(2) Assisting families in identifying
				available services.
(3)
				Coordinating and monitoring the authorization, scheduling, and performance of
				assessments and services.
(4)
				Participating and facilitating in the development, review, and evaluation of
				the IFSP.
(5) Assisting in the
				identification and access to available financial support.
(6) Informing families of the availability of
				advocacy services.
(7) Coordinating
				and participating in the development of a transition plan for infants and
				toddlers into, within, and from the early intervention system to preschool, or
				other appropriate services at or prior to three (3) years of age, or when the
				child is no longer eligible for early intervention services.
Indiana Administrative Code › Title 405 - OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES › Article 5 - MEDICAID SERVICES › Rule 35 - Case Management Services for Infants and Toddlers with Disabilities › Section 35-2 - Providers eligible for reimbursement; certification

Current through July 10, 2024
Authority: IC
				  12-15-1-10; IC
				  12-15-21-2; IC
				  12-15-21-3
Affected: IC 12-15
Sec. 2.
Medicaid reimbursement is available for service coordination
				  services provided to eligible children by either of the following, after he or
				  she has been certified by and has successfully completed orientation to the
				  First Steps Early Intervention system:
(1) Service coordinator specialist.
(2) Service coordinator associate.
Indiana Administrative Code › Title 405 - OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES › Article 5 - MEDICAID SERVICES › Rule 35 - Case Management Services for Infants and Toddlers with Disabilities › Section 35-3 - Covered services

Current through July 10, 2024
Authority: IC
				  12-15-1-10; IC
				  12-15-21-2; IC
				  12-15-21-3
Affected: IC 12-15
Sec. 3.
The following are service coordination services that may be
				  reimbursed by Medicaid:
(1)
				Development of the IFSP based on fifteen (15) minute increments of face-to-face
				contact of up to two and one-half (2-) hours per meeting and with a maximum
				time limit of seven and one-half (7-) hours annually, per eligible
				child.
(2) Ongoing service
				coordination services, based on a minimum of fifteen (15) minutes of contact,
				with a maximum of four (4) contacts per month, that consist of the following:
(A) Assessment of the eligible child's
				needs.
(B) Coordination and
				advocacy.
(C) Monitoring the
				IFSP.
(D) Evaluation of the IFSP.
				Direct face-to-face service coordination with the family of the eligible child
				must occur and be documented at least four (4) times per
				year.
Indiana Administrative Code › Title 405 - OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES › Article 5 - MEDICAID SERVICES › Rule 35 - Case Management Services for Infants and Toddlers with Disabilities › Section 35-4 - Prior authorization

Current through July 10, 2024
Authority: IC
				  12-15-1-10; IC
				  12-15-21-2; IC
				  12-15-21-3
Affected: IC 12-15
Sec. 4.
Service coordination services are exempt from prior
				  authorization requirements.
Indiana Administrative Code › Title 405 - OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES › Article 5 - MEDICAID SERVICES › Rule 36 - Diabetes Self Management Training › Section 36-1 - DSMT policy; definitions

Current through July 10, 2024
Authority: IC
				  12-15-1-10; IC
				  12-15-21-2; IC
				  12-15-21-3
Affected: IC 12-15; IC
				  27-8-14.5-6
Sec. 1.
(a)
				Reimbursement is available for diabetes self management training, as defined in
				this rule and when provided in accordance with all applicable provisions of
				this rule, provider bulletins, provider manuals, and the provider
				agreement.
(b) As used in this
				rule, "DSMT" means diabetes self management training and is comprised of those
				services provided in accordance with IC
				27-8-14.5-6. These services are
				intended to enable the member to, or enhance the member's ability to, properly
				manage the member's diabetic condition, thereby optimizing the member's own
				therapeutic regimen. Examples of DSMT include, but are not limited to, the
				following:
(1) Instruction regarding the
				diabetic disease state, nutrition, exercise, and activity.
(2) Medications counseling.
(3) Blood glucose self-monitoring
				training.
(4) Foot, skin, and
				dental care.
(5) Behavior change
				strategies and risk factor reduction.
(6) Preconception care, pregnancy, and
				gestational diabetes.
(7) Accessing
				community health care systems and resources.
Indiana Administrative Code › Title 405 - OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES › Article 5 - MEDICAID SERVICES › Rule 36 - Diabetes Self Management Training › Section 36-2 - Requirements for the provision of DSMT

Current through July 10, 2024
Authority: IC
				  12-15-1-10; IC
				  12-15-21-2; IC
				  12-15-21-3
Affected: IC 12-15; IC
				  27-8-14.5
Sec. 2.
(a) DSMT must
				be medically necessary for the patient.
(b) DSMT must be ordered in writing by a
				physician or podiatrist licensed under applicable Indiana law.
(c) DSMT must be provided by a health care
				professional licensed under applicable Indiana law.
(d) The health care professional that
				provides DSMT must have specialized training in the management of diabetes.
Indiana Administrative Code › Title 405 - OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES › Article 5 - MEDICAID SERVICES › Rule 36 - Diabetes Self Management Training › Section 36-3 - Limitations on coverage of DSMT

Current through July 10, 2024
Authority: IC 12-15-1-10; IC 12-15-21-2; IC 12-15-21-3
Affected: IC 12-15; IC 27-8-14.5
Sec. 3.
(a) Coverage
				of DSMT is limited to sixteen (16) units of DSMT per member, per rolling
				calendar year without prior authorization. Additional units of DSMT may be
				authorized via the prior authorization process as set forth in
				405 IAC 5-3.
(b) Coverage of DSMT is limited to the
				following clinical circumstances:
(1) Receipt
				of a diagnosis of diabetes.
(2)
				Receipt of a diagnosis that represents a significant change in the patient's
				symptoms or condition.
(3)
				Re-education or refresher training.
Indiana Administrative Code › Title 405 - OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES › Article 5 - MEDICAID SERVICES › Rule 37 - Tobacco Dependence Treatment Policy › Section 37-0.5 - Definitions

Current through July 10, 2024
Authority: IC
				  12-15-1-10; IC
				  12-15-21-2; IC
				  12-15-21-3
Affected: IC 12-15
Sec. 0.5.
The following definitions apply throughout this rule:
(1) "Tobacco dependence treatment" means the
				provision of products and services intended to reduce a person's dependence on
				tobacco products. The term includes the provision of the following:
(A) Covered legend or nonlegend drugs
				intended to reduce an individual's dependence on tobacco products.
(B) Tobacco dependence counseling services
				offered in conjunction with the delivery of a drug defined in clause (A) or by
				an individual identified under section 3 of this rule.
Indiana Administrative Code › Title 405 - OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES › Article 5 - MEDICAID SERVICES › Rule 37 - Tobacco Dependence Treatment Policy › Section 37-1 - Reimbursement and prior authorization

Current through July 10, 2024
Authority: IC 12-15-1-10; IC 12-15-21-2; IC 12-15-21-3
Affected: IC 12-15
Sec. 1.
(a)
				Reimbursement is available for tobacco dependence treatment subject to the
				requirements set forth in this rule and when provided in accordance with
				provider bulletins, provider manuals, and the provider agreement.
(b) Tobacco dependence products may be
				subject to prior authorization as defined in
				405 IAC 5-2-20. A provider
				seeking prior authorization shall follow the process outlined in
				405 IAC 5-3.
Indiana Administrative Code › Title 405 - OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES › Article 5 - MEDICAID SERVICES › Rule 37 - Tobacco Dependence Treatment Policy › Section 37-2 - Tobacco dependence products

Current through July 10, 2024
Authority: IC 12-15-1-10; IC 12-15-21-2; IC 12-15-21-3
Affected: IC 12-15
Sec. 2.
(a)
				Reimbursement is available to pharmacy providers for tobacco dependence
				products when prescribed by a practitioner within the scope of his or her
				license under Indiana law.
(b) In
				order for a pharmacy provider to receive reimbursement under this section for
				tobacco dependence products, the tobacco dependence product must be covered by
				Indiana Medicaid in accordance with
				405 IAC 5-24-3 or
				405 IAC 5-24-5.
(c) A member prescribed a legend or nonlegend
				drug intended to reduce an individual's dependence on tobacco products must
				engage in tobacco dependence counseling in conjunction with the receipt of said
				legend or nonlegend drug therapy.
Indiana Administrative Code › Title 405 - OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES › Article 5 - MEDICAID SERVICES › Rule 37 - Tobacco Dependence Treatment Policy › Section 37-3 - Tobacco dependence counseling

Current through July 10, 2024
Authority: IC
				  12-15-1-10; IC
				  12-15-21-2; IC
				  12-15-21-3
Affected: IC 12-15
Sec. 3.
(a)
				Reimbursement is available for tobacco dependence counseling services rendered
				by licensed practitioners under applicable Indiana law participating in
				Medicaid and listed in subsection (c).
(b) A prescription for tobacco dependence
				products serves as documentation that the prescribing practitioner has
				prescribed or obtained assurance from the patient that counseling occurs
				corresponding to the receipt of tobacco dependence products.
(c) The following may provide tobacco
				dependence counseling services when prescribed by a practitioner within the
				scope of his or her license under Indiana law and within the limitations of
				this rule:
(1) A physician.
(2) A physician's assistant.
(3) A nurse practitioner.
(4) A registered nurse.
(5) A psychologist.
(6) A pharmacist.
(7) A dentist.
(8) An optometrist
(9) A clinical social worker.
(10) A marital and family
				counselor.
(11) A mental health
				counselor.
(12) A licensed clinical
				addictions counselor.
Indiana Administrative Code › Title 405 - OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES › Article 5 - MEDICAID SERVICES › Rule 38 - Telemedicine Services › Section 38-2 - Definitions

Current through July 10, 2024
Authority: IC
				  12-15-1-10; IC
				  12-15-21-2; IC
				  12-15-21-3
Affected: IC
				  12-13-7-3; IC 12-15
Sec. 2.
The following definitions apply throughout this rule:
(1) "Distant site" means a site at which a
				provider is located while providing health care services through
				telemedicine.
(2) "Interactive
				television" or "IATV" means the videoconferencing equipment at the distant and
				originating site that allows real time, face-to-face consultation.
(3) "Originating site" means any site at
				which a patient is located at the time health care services through
				telemedicine are provided to the individual.
(4) "Store and forward" means the
				transmission of a patient's medical information from an originating site to the
				provider at a distant site without the patient being present for subsequent
				review by a health care provider at the distant site. Restrictions placed on
				store and forward reimbursement in this rule shall not disallow the permissible
				use of store and forward technology to facilitate reimbursable
				services.
Indiana Administrative Code › Title 405 - OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES › Article 5 - MEDICAID SERVICES › Rule 38 - Telemedicine Services › Section 38-3 - Description of service

Current through July 10, 2024
Authority: IC
				  12-15-1-10; IC
				  12-15-21-2; IC
				  12-15-21-3
Affected: IC
				  12-13-7-3; IC 12-15
Sec. 3.
(a) In any
				telemedicine encounter, there will be the following:
(1) A distant site.
(2) An originating site.
(3) An attendant to connect the patient to
				the provider at the distant site.
(4) A computer or television monitor to allow
				the patient to have:
(A) real-time;
(B) interactive; and
(C) face-to-face; communication with the
				distant provider via IATV technology.
Indiana Administrative Code › Title 405 - OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES › Article 5 - MEDICAID SERVICES › Rule 38 - Telemedicine Services › Section 38-4 - Limitations

Current through July 10, 2024
Authority: IC
				  12-15-5-11; IC
				  12-15-21
Affected: IC
				  12-13-7-3
Sec. 4.
Telemedicine shall be limited by the following
				  conditions:
(1) The patient must:
(A) be physically present at the originating
				site; and
(B) participate in the
				visit.
Indiana Administrative Code › Title 405 - OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES › Article 5 - MEDICAID SERVICES › Rule 39 - End Stage Renal Disease Services › Section 39-1 - General provisions

Current through July 10, 2024
Authority: IC
				  12-15-1-10; IC
				  12-15-1-15; IC
				  12-15-21-2; IC
				  12-15-21-3
Affected: IC
				  12-13-7-3; IC 12-15
Sec. 1.
(a) End stage
				renal disease (ESRD) services refer to a fee-for-service delivery system for
				certain services, including admission to nursing facilities and nonemergency
				medical transportation (NEMT). ESRD services are covered by Medicaid within the
				parameters specified in this rule.
(b) The following services are not covered
				under this rule:
(1) Swing beds in a skilled
				nursing facility.
(2) Long term
				care services, including nursing facility, home and community based waiver, and
				ICF/IID services.
Indiana Administrative Code › Title 405 - OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES › Article 5 - MEDICAID SERVICES › Rule 39 - End Stage Renal Disease Services › Section 39-2 - Description of benefits

Current through July 10, 2024
Authority: IC
				  12-15-1-10; IC
				  12-15-1-15; IC
				  12-15-21-2; IC
				  12-15-21-3
Affected: IC
				  12-13-7-3; IC 12-15
Sec. 2.
Individuals eligible for end stage renal disease (ESRD)
				  services under this rule will be eligible for state plan benefits for monthly
				  incurred medical costs that exceed the difference between the member's
				  countable income and the monthly equivalent of one hundred percent (100%) FPL.
				  This coverage is considered minimal essential coverage (MEC), pursuant to
				  42 CFR
				  156 Subpart G. Those eligible individuals may
				  receive the following:
(1)
				Expenditures incurred for any services received while an ESRD enrollee is an
				inpatient in a long term care institutional setting will not be claimed under
				the demonstration. Any individual enrolled in the ESRD demonstration who is
				admitted to a nursing facility or other long term care setting, either
				temporarily (for less than thirty (30) days) or for a longer admission, will be
				assessed for eligibility under a Medicaid state plan covered category. Such
				individuals will be disenrolled from the demonstration upon admission to an
				institution or approval for HCBS waivers services, and will be assessed for
				reenrollment into the demonstration upon discharge from the institutional or
				other long term care setting.
(2)
				Individuals affected by this demonstration shall receive benefits in the form
				of a service to ensure nonemergency transportation to and from providers. The
				state must report in the quarterly reports any complaints or issues regarding
				nonemergency medical transportation (NEMT).
Indiana Administrative Code › Title 405 - OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES › Article 5 - MEDICAID SERVICES › Rule 39 - End Stage Renal Disease Services › Section 39-3 - Enrollment and redetermination of eligibility

Current through July 10, 2024
Authority: IC
				  12-15-1-10; IC
				  12-15-1-15; IC
				  12-15-21-2; IC
				  12-15-21-3
Affected: IC
				  12-13-7-3; IC 12-15
Sec. 3.
(a) New
				enrollees are required to submit an application and complete an in-person
				assessment.
(b) Enrollees are
				required to complete annual eligibility redeterminations.
Indiana Administrative Code › Title 405 - OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES › Article 7 - STATE SUPPLEMENTAL ASSISTANCE FOR PERSONAL NEEDS › Rule 1 - Eligibility Requirements › Section 1-1 - Eligibility; benefit calculation

Current through July 10, 2024
Authority: IC 12-15-1-10
Affected: IC 12-15-7-2; IC 12-15-7-6; IC 12-15-32-6.5
Sec. 1.
(a) An
				individual is eligible for supplemental assistance for personal needs if the
				following criteria are met:
(1) The individual
				is receiving Medicaid and is residing in a Medicaid certified health care
				facility.
(2) The individual is
				receiving the reduced benefit amount paid by the Supplemental Security Income
				(SSI) program under
				20
				CFR 416.414 to SSI recipients who are in
				medical care facilities throughout a calendar month.
(3) The individual qualifies for a benefit
				based on his or her income as required in subsection (b).
Indiana Administrative Code › Title 405 - OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES › Article 7 - STATE SUPPLEMENTAL ASSISTANCE FOR PERSONAL NEEDS › Rule 2 - Benefit Issuance › Section 2-1 - Benefit issuance; representative payee

Current through July 10, 2024
Authority: IC
				  12-15-1-10
Affected: IC
				  12-15-7-2;
				  IC
				  12-15-7-6;
				  IC
				  12-15-32-6.5
Sec. 1.
(a) A benefit
				check shall be issued not later than five (5) calendar days after the first day
				of each benefit month in the name of the eligible individual or to a
				representative payee authorized in accordance with subsection (d).
(b) Lost or stolen checks shall be reissued
				not later than fifteen (15) days after the recipient or representative payee
				submits to the local office of family and children the proper affidavit
				prescribed by Indiana and signed by the payee confirming that the check was not
				received.
(c) Benefit checks that
				are returned in the mail will be reissued in accordance with the procedures of
				the state auditor's office, not later than fifteen (15) days after written
				documentation from the payee of the correct and current address of the
				payee.
(d) An individual who signs
				the representative payee agreement for state supplemental assistance for
				personal needs will be permitted to receive the benefit check on behalf of the
				recipient if the recipient does not object. A representative payee must use the
				benefit check solely for the personal needs of the recipient. If, at any time,
				proof is submitted to the satisfaction of the local office of family and
				children that a representative payee is not fulfilling his or her obligations
				under the agreement to provide for the personal needs of the recipient, the
				local office of family and children may require that another individual be
				selected as the representative payee.
Indiana Administrative Code › Title 405 - OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES › Article 8 - INDIANA PRESCRIPTION DRUG PROGRAM MEDICARE PART D ASSISTANCE BENEFIT › Rule 1 - General Provisions › Section 1-1 - Intent and purpose

Current through July 10, 2024
Authority: IC
				  12-10-16-5
Affected: IC
				  12-10-16-3
Sec. 1.
Under IC
				  12-10-16-3,
				  the office hereby adopts and promulgates this article to do the
				  following:
(1) Interpret and implement
				provisions of IC
				12-10-16-3
				to provide assistance to low-income seniors with the expense of participating
				in a Medicare Part D plan.
(2)
				Ensure the efficient, economical, and reasonable operations of the Indiana
				prescription drug program.
Indiana Administrative Code › Title 405 - OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES › Article 8 - INDIANA PRESCRIPTION DRUG PROGRAM MEDICARE PART D ASSISTANCE BENEFIT › Rule 2 - Definitions › Section 2-1 - Applicability

Current through July 10, 2024
Authority: IC
				  12-10-16-5
Affected: IC 12-10-16
Sec. 1.
The definitions in this rule apply throughout this article
				  unless the context clearly indicates another meaning.
Indiana Administrative Code › Title 405 - OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES › Article 8 - INDIANA PRESCRIPTION DRUG PROGRAM MEDICARE PART D ASSISTANCE BENEFIT › Rule 2 - Definitions › Section 2-2 - "Applicant" defined

Current through July 10, 2024
Authority: IC
				  12-10-16-5
Affected: IC 12-10-16
Sec. 2.
"Applicant" means the person for whom Indiana prescription
				  drug program enrollment is requested.
Indiana Administrative Code › Title 405 - OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES › Article 8 - INDIANA PRESCRIPTION DRUG PROGRAM MEDICARE PART D ASSISTANCE BENEFIT › Rule 2 - Definitions › Section 2-3 - "Benefit period" defined

Current through July 10, 2024
Authority: IC 12-10-16-5
Affected: IC 12-10-16
Sec. 3.
"Benefit period" means a specified time frame during which a
				  member is concurrently enrolled in both a Medicare Part D plan and the Indiana
				  prescription drug program. The benefit period shall not exceed one (1) calendar
				  year beginning in January with limits specified in
				  405 IAC
				  8-6-4. The benefit shall not be paid or begin until
				  the first day of the first month in which:
(1) the member has an active effective date
				in a Medicare Part D plan; and
(2)
				the member's Medicare Part D plan recognizes the member's enrollment in the
				IPDP.
Indiana Administrative Code › Title 405 - OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES › Article 8 - INDIANA PRESCRIPTION DRUG PROGRAM MEDICARE PART D ASSISTANCE BENEFIT › Rule 2 - Definitions › Section 2-4 - "Centers for Medicare and Medicaid Services" defined

Current through July 10, 2024
Authority: IC
				  12-10-16-5
Affected: IC 12-10-16
Sec. 4.
"Centers for Medicare and Medicaid Services" means the
				  federal administrator of the Medicare prescription drug
				  benefit.
Indiana Administrative Code › Title 405 - OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES › Article 8 - INDIANA PRESCRIPTION DRUG PROGRAM MEDICARE PART D ASSISTANCE BENEFIT › Rule 2 - Definitions › Section 2-5 - "Complete applicant file" defined

Current through July 10, 2024
Authority: IC
				  12-10-16-5
Affected: IC 12-10-16
Sec. 5.
(a)
				"Complete applicant file" means an enrollment form for the Indiana prescription
				drug program that includes the following information about the applicant and
				applicant's spouse, if applicable:
(1)
				Name.
(2) Address of
				domicile.
(3) Date of
				birth.
(4) Social Security
				number.
(5) Medicare Health
				Insurance Claim Number (HICN).
(6)
				Marital status.
(7)
				Signature.
(8) Proof of low-income
				subsidy determination by the Social Security Administration. Proof includes
				either a letter of determination from the Social Security Administration or
				electronic confirmation provided by the Centers for Medicare and Medicaid
				Services.
(9) Proof that the
				applicant's income is below one hundred fifty percent (150%) of the federal
				poverty limit applicable to the individual's family size.
(10) Proof of enrollment in a Medicare
				prescription drug plan. Acceptable proof should be electronic confirmation
				provided by the Centers for Medicare and Medicaid Services or a Medicare Part D
				plan member identification number.
Indiana Administrative Code › Title 405 - OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES › Article 8 - INDIANA PRESCRIPTION DRUG PROGRAM MEDICARE PART D ASSISTANCE BENEFIT › Rule 2 - Definitions › Section 2-6 - "Deductible" defined

Current through July 10, 2024
Authority: IC
				  12-10-16-5
Affected: IC 12-10-16
Sec. 6.
"Deductible" means the amount a beneficiary must pay
				  out-of-pocket before the member's Medicare Part D plan begins to cover
				  prescription drug costs during each benefit period.
Indiana Administrative Code › Title 405 - OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES › Article 8 - INDIANA PRESCRIPTION DRUG PROGRAM MEDICARE PART D ASSISTANCE BENEFIT › Rule 2 - Definitions › Section 2-7 - "Domicile" defined

Current through July 10, 2024
Authority: IC
				  12-10-16-5
Affected: IC 12-10-16
Sec. 7.
"Domicile" means the applicant's:
(1) true;
(2) fixed;
(3) principal; and
(4) permanent; home.
Indiana Administrative Code › Title 405 - OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES › Article 8 - INDIANA PRESCRIPTION DRUG PROGRAM MEDICARE PART D ASSISTANCE BENEFIT › Rule 2 - Definitions › Section 2-8 - "Eligible" defined

Current through July 10, 2024
Authority: IC
				  12-10-16-5
Affected: IC 12-10-16
Sec. 8.
"Eligible" means a person who meets all requirements for
				  enrollment in the program.
Indiana Administrative Code › Title 405 - OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES › Article 8 - INDIANA PRESCRIPTION DRUG PROGRAM MEDICARE PART D ASSISTANCE BENEFIT › Rule 2 - Definitions › Section 2-9 - "Enhanced Medicare Part D plan" defined

Current through July 10, 2024
Authority: IC
				  12-10-16-5
Affected: IC 12-10-16
Sec. 9.
"Enhanced Medicare Part D plan" means a Medicare Part D plan
				  that is not considered standard or basic actuarially equivalent standard
				  coverage by the Centers for Medicare and Medicaid Services.
Indiana Administrative Code › Title 405 - OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES › Article 8 - INDIANA PRESCRIPTION DRUG PROGRAM MEDICARE PART D ASSISTANCE BENEFIT › Rule 2 - Definitions › Section 2-10 - "Federal poverty limit" or "FPL" defined

Current through July 10, 2024
Authority: IC
				  12-10-16-5
Affected: IC 12-10-16
Sec. 10.
"Federal poverty limit" means the nonfarm income official
				  poverty guideline as determined by the federal Office of Management and
				  Budget.
Indiana Administrative Code › Title 405 - OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES › Article 8 - INDIANA PRESCRIPTION DRUG PROGRAM MEDICARE PART D ASSISTANCE BENEFIT › Rule 2 - Definitions › Section 2-11 - "Full low-income subsidy" defined

Current through July 10, 2024
Authority: IC
				  12-10-16-5
Affected: IC 12-10-16
Sec. 11.
"Full low-income subsidy" means the full extra help for
				  paying for Medicare prescription drug plan costs provided by the Centers for
				  Medicare and Medicaid Services (CMS). According to CMS, beneficiaries receiving
				  "full low-income subsidy" will:
(1)
				not be responsible for monthly premium costs for basic Medicare Part D
				plans;
(2) have no annual
				deductible; and
(3) have no gap in
				coverage.
Indiana Administrative Code › Title 405 - OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES › Article 8 - INDIANA PRESCRIPTION DRUG PROGRAM MEDICARE PART D ASSISTANCE BENEFIT › Rule 2 - Definitions › Section 2-12 - "Income" defined

Current through July 10, 2024
Authority: IC
				  12-10-16-5
Affected: IC 12-10-16
Sec. 12.
"Income" means the amount of money or its equivalent received
				  as follows:
(1) In exchange for or as
				a result of labor or services.
(2)
				From the sale of goods or property.
(3) As profits from financial
				investments.
Indiana Administrative Code › Title 405 - OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES › Article 8 - INDIANA PRESCRIPTION DRUG PROGRAM MEDICARE PART D ASSISTANCE BENEFIT › Rule 2 - Definitions › Section 2-13 - "Indiana prescription drug program" defined

Current through July 10, 2024
Authority: IC
				  12-10-16-5
Affected: IC 12-10-16
Sec. 13.
"Indiana prescription drug program" means the program
				  established by IC 12-10-16.
Indiana Administrative Code › Title 405 - OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES › Article 8 - INDIANA PRESCRIPTION DRUG PROGRAM MEDICARE PART D ASSISTANCE BENEFIT › Rule 2 - Definitions › Section 2-15 - "Low-income subsidy" defined

Current through July 10, 2024
Authority: IC
				  12-10-16-5
Affected: IC 12-10-16
Sec. 15.
" Low-income subsidy" means either:
(1) a full low-income subsidy;
(2) or partial low-income subsidy; as
				determined and defined by the Social Security
				Administration.
Indiana Administrative Code › Title 405 - OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES › Article 8 - INDIANA PRESCRIPTION DRUG PROGRAM MEDICARE PART D ASSISTANCE BENEFIT › Rule 2 - Definitions › Section 2-16 - "Low-income subsidy application" defined

Current through July 10, 2024
Authority: IC
				  12-10-16-5
Affected: IC 12-10-16
Sec. 16.
" Low-income subsidy application" means the Application for
				  Help with Medicare Prescription Drug Plan Costs, which is processed and
				  administered through the Social Security Administration.
Indiana Administrative Code › Title 405 - OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES › Article 8 - INDIANA PRESCRIPTION DRUG PROGRAM MEDICARE PART D ASSISTANCE BENEFIT › Rule 2 - Definitions › Section 2-17 - "Low-income subsidy determination" defined

Current through July 10, 2024
Authority: IC
				  12-10-16-5
Affected: IC 12-10-16
Sec. 17.
" Low-income subsidy determination" means a "Notice of Award"
				  or "Notice of Denial" determination from the Social Security Administration as
				  to an applicant's eligibility for the low-income subsidy.
Indiana Administrative Code › Title 405 - OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES › Article 8 - INDIANA PRESCRIPTION DRUG PROGRAM MEDICARE PART D ASSISTANCE BENEFIT › Rule 2 - Definitions › Section 2-18 - "Low-income subsidy premium" defined

Current through July 10, 2024
Authority: IC
				  12-10-16-5
Affected: IC 12-10-16
Sec. 18.
" Low-income subsidy premium" means the maximum amount the
				  low-income subsidy will pay towards a Medicare Part D beneficiary's monthly
				  premium in the state of Indiana, as determined by the Centers for Medicare and
				  Medicaid Services and adjusted annually.
Indiana Administrative Code › Title 405 - OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES › Article 8 - INDIANA PRESCRIPTION DRUG PROGRAM MEDICARE PART D ASSISTANCE BENEFIT › Rule 2 - Definitions › Section 2-19 - "Medicare-Advantage prescription drug plan" defined

Current through July 10, 2024
Authority: IC
				  12-10-16-5
Affected: IC 12-10-16
Sec. 19.
"Medicare-Advantage prescription drug plan" means an entity
				  authorized by the Centers for Medicare and Medicaid Services to provide
				  prescription drug coverage to Medicare-Advantage
				  beneficiaries.
Indiana Administrative Code › Title 405 - OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES › Article 8 - INDIANA PRESCRIPTION DRUG PROGRAM MEDICARE PART D ASSISTANCE BENEFIT › Rule 2 - Definitions › Section 2-20 - "Medicare Part D plan" defined

Current through July 10, 2024
Authority: IC
				  12-10-16-5
Affected: IC 12-10-16
Sec. 20.
"Medicare Part D plan" means a:
(1) Medicare prescription drug plan;
				or
(2) Medicare-Advantage
				prescription drug plan.
Indiana Administrative Code › Title 405 - OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES › Article 8 - INDIANA PRESCRIPTION DRUG PROGRAM MEDICARE PART D ASSISTANCE BENEFIT › Rule 2 - Definitions › Section 2-21 - "Medicare prescription drug plan" defined

Current through July 10, 2024
Authority: IC
				  12-10-16-5
Affected: IC 12-10-16
Sec. 21.
"Medicare prescription drug plan" means an entity authorized
				  by the Centers for Medicare and Medicaid Services to provide prescription drug
				  coverage to Medicare beneficiaries.
Indiana Administrative Code › Title 405 - OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES › Article 8 - INDIANA PRESCRIPTION DRUG PROGRAM MEDICARE PART D ASSISTANCE BENEFIT › Rule 2 - Definitions › Section 2-22 - "Member" defined

Current through July 10, 2024
Authority: IC
				  12-10-16-5
Affected: IC 12-10-16
Sec. 22.
"Member" means a person who has:
(1) met all eligibility requirements;
				and
(2) been enrolled in the
				Indiana prescription drug program.
Indiana Administrative Code › Title 405 - OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES › Article 8 - INDIANA PRESCRIPTION DRUG PROGRAM MEDICARE PART D ASSISTANCE BENEFIT › Rule 2 - Definitions › Section 2-24 - "Not eligible for the Indiana prescription drug program" defined

Current through July 10, 2024
Authority: IC
				  12-10-16-5
Affected: IC 12-10-16
Sec. 24.
"Not eligible for the Indiana prescription drug program"
				  means the applicant does not meet one (1) or more of the eligibility
				  requirements for enrollment in the program.
Indiana Administrative Code › Title 405 - OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES › Article 8 - INDIANA PRESCRIPTION DRUG PROGRAM MEDICARE PART D ASSISTANCE BENEFIT › Rule 2 - Definitions › Section 2-25 - "Office" defined

Current through July 10, 2024
Authority: IC
				  12-10-16-5
Affected: IC 12-10-16
Sec. 25.
"Office" means the office of the secretary of family and
				  social services.
Indiana Administrative Code › Title 405 - OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES › Article 8 - INDIANA PRESCRIPTION DRUG PROGRAM MEDICARE PART D ASSISTANCE BENEFIT › Rule 2 - Definitions › Section 2-26 - "Partial low-income subsidy" defined

Current through July 10, 2024
Authority: IC
				  12-10-16-5
Affected: IC 12-10-16
Sec. 26.
" Parti al low-income subsidy" means the partial extra help
				  for paying for Medicare prescription drug plan costs provided by the Centers
				  for Medicare and Medicaid Services. According to CMS, beneficiaries receiving
				  "partial low-income subsidy" will:
(1) be
				  responsible for monthly premium on a sliding scale for standard Medicare Part D
				  plans;
(2) have a reduced annual
				  deductible; and
(3) have no gap in
				  coverage.
Indiana Administrative Code › Title 405 - OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES › Article 8 - INDIANA PRESCRIPTION DRUG PROGRAM MEDICARE PART D ASSISTANCE BENEFIT › Rule 2 - Definitions › Section 2-27 - "Premium" defined

Current through July 10, 2024
Authority: IC
				  12-10-16-5
Affected: IC 12-10-16
Sec. 27.
"Premium" means the monthly cost of being enrolled in a
				  Medicare prescription drug plan.
Indiana Administrative Code › Title 405 - OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES › Article 8 - INDIANA PRESCRIPTION DRUG PROGRAM MEDICARE PART D ASSISTANCE BENEFIT › Rule 2 - Definitions › Section 2-28 - "Prescription drug" defined

Current through July 10, 2024
Authority: IC
				  12-10-16-5
Affected: IC 12-10-16
Sec. 28.
"Prescription drug" means any prescription drug that is not a
				  noncovered drug.
Indiana Administrative Code › Title 405 - OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES › Article 8 - INDIANA PRESCRIPTION DRUG PROGRAM MEDICARE PART D ASSISTANCE BENEFIT › Rule 2 - Definitions › Section 2-29 - "Program" defined

Current through July 10, 2024
Authority: IC
				  12-10-16-5
Affected: IC 12-10-16
Sec. 29.
"Program" means the Indiana prescription drug
				  program.
Indiana Administrative Code › Title 405 - OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES › Article 8 - INDIANA PRESCRIPTION DRUG PROGRAM MEDICARE PART D ASSISTANCE BENEFIT › Rule 2 - Definitions › Section 2-30 - "Proof of income" defined

Current through July 10, 2024
Authority: IC
				  12-10-16-5
Affected: IC 12-10-16
Sec. 30.
"Proof of income" means documentation of the income of an
				  applicant and an applicant's family. Proof of income for the program should be
				  provided by the Social Security Administration through the low-income subsidy
				  application. If the Social Security Administration's low-income subsidy
				  determination does not include an income determination, the office may ask the
				  applicant to provide proof of income.
Indiana Administrative Code › Title 405 - OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES › Article 8 - INDIANA PRESCRIPTION DRUG PROGRAM MEDICARE PART D ASSISTANCE BENEFIT › Rule 2 - Definitions › Section 2-31 - "Provider" defined

Current through July 10, 2024
Authority: IC 12-10-16-5
Affected: IC 12-10-16
Sec. 31.
"Provider" means an entity that:
(1) provides Medicare prescription drug
				coverage through a Medicare Part D plan in the state of Indiana; and
(2) participates in the program in accordance
				with
				405
				IAC 8-6-1(a)  and
				405
				IAC 8-6-2(b).
Indiana Administrative Code › Title 405 - OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES › Article 8 - INDIANA PRESCRIPTION DRUG PROGRAM MEDICARE PART D ASSISTANCE BENEFIT › Rule 2 - Definitions › Section 2-32 - "Secretary" defined

Current through July 10, 2024
Authority: IC
				  12-10-16-5
Affected: IC 12-10-16
Sec. 32.
"Secretary" means the secretary of family and social
				  services.
Indiana Administrative Code › Title 405 - OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES › Article 8 - INDIANA PRESCRIPTION DRUG PROGRAM MEDICARE PART D ASSISTANCE BENEFIT › Rule 2 - Definitions › Section 2-33 - "Senior" defined

Current through July 10, 2024
Authority: IC
				  12-10-16-5
Affected: IC 12-10-16
Sec. 33.
"Senior" means a person at least sixty-five (65) years of
				  age.
Indiana Administrative Code › Title 405 - OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES › Article 8 - INDIANA PRESCRIPTION DRUG PROGRAM MEDICARE PART D ASSISTANCE BENEFIT › Rule 2 - Definitions › Section 2-34 - "Spouse" defined

Current through July 10, 2024
Authority: IC
				  12-10-16-5
Affected: IC 12-10-16
Sec. 34.
"Spouse" means the legal husband or wife of an
				  applicant.
Indiana Administrative Code › Title 405 - OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES › Article 8 - INDIANA PRESCRIPTION DRUG PROGRAM MEDICARE PART D ASSISTANCE BENEFIT › Rule 2 - Definitions › Section 2-35 - "Standard" defined

Current through July 10, 2024
Authority: IC
				  12-10-16-5
Affected: IC 12-10-16
Sec. 35.
"Standard" means a Medicare Part D plan that is considered
				  standard or basic actuarially equivalent standard coverage by the Centers for
				  Medicare and Medicaid Services. The term excludes enhanced plans.
Indiana Administrative Code › Title 405 - OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES › Article 8 - INDIANA PRESCRIPTION DRUG PROGRAM MEDICARE PART D ASSISTANCE BENEFIT › Rule 2 - Definitions › Section 2-36 - "True out-of-pocket costs" defined

Current through July 10, 2024
Authority: IC
				  12-10-16-5
Affected: IC 12-10-16
Sec. 36.
"True out-of-pocket costs" means prescription drug costs that
				  count towards a member's Medicare Part D plan maximum out-of-pocket
				  costs.
Indiana Administrative Code › Title 405 - OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES › Article 8 - INDIANA PRESCRIPTION DRUG PROGRAM MEDICARE PART D ASSISTANCE BENEFIT › Rule 2 - Definitions › Section 2-37 - "Unearned income" defined

Current through July 10, 2024
Authority: IC
				  12-10-16-5
Affected: IC 12-10-16
Sec. 37.
"Unearned income" means income the applicant receives from a
				  source other than employment including, but not limited to, Social Security,
				  pensions, or income from assets.
Indiana Administrative Code › Title 405 - OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES › Article 8 - INDIANA PRESCRIPTION DRUG PROGRAM MEDICARE PART D ASSISTANCE BENEFIT › Rule 3 - Eligibility Requirements › Section 3-1 - Age

Current through July 10, 2024
Authority: IC
				  12-10-16-5
Affected: IC 12-10-16
Sec. 1.
To be eligible for program benefits, an applicant must be at
				  least sixty-five (65) years of age.
Indiana Administrative Code › Title 405 - OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES › Article 8 - INDIANA PRESCRIPTION DRUG PROGRAM MEDICARE PART D ASSISTANCE BENEFIT › Rule 3 - Eligibility Requirements › Section 3-2 - Income

Current through July 10, 2024
Authority: IC
				  12-10-16-5
Affected: IC 12-10-16
Sec. 2.
To be eligible for program benefits, an applicant's gross
				  income must not exceed one hundred fifty percent (150%) of the federal poverty
				  limit applicable to the individual's family size, as defined by the federal
				  Office of Management and Budget. A general income disregard of twenty dollars
				  ($20) is allowed and applied per household. It is deducted from the total
				  monthly gross income when an income determination is made.
Indiana Administrative Code › Title 405 - OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES › Article 8 - INDIANA PRESCRIPTION DRUG PROGRAM MEDICARE PART D ASSISTANCE BENEFIT › Rule 3 - Eligibility Requirements › Section 3-3 - Ineligibility

Current through July 10, 2024
Authority: IC
				  12-10-16-5
Affected: IC 12-10-16
Sec. 3.
Notwithstanding any other provision of this article, an
				  individual is not eligible for the program if any of the following
				  apply:
(1) The applicant is not a
				Medicare beneficiary.
(2) The
				individual:
(A) is not domiciled in
				Indiana;
(B) does not intend to
				reside permanently in the state of Indiana;
(C) has not received a low-income subsidy
				determination from Social Security Administration;
(D) has been determined eligible for full
				low-income subsidy;
(E) is dually
				eligible for both Medicare and full Medicaid;
(F) is an inmate of a correctional facility;
				or
(G) is not enrolled in a
				Medicare Part D plan.
Indiana Administrative Code › Title 405 - OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES › Article 8 - INDIANA PRESCRIPTION DRUG PROGRAM MEDICARE PART D ASSISTANCE BENEFIT › Rule 4 - Application and Enrollment › Section 4-1 - General requirements

Current through July 10, 2024
Authority: IC
				  12-10-16-5
Affected: IC 12-10-16
Sec. 1.
(a) A
				completed applicant file will be processed by the office and must include
				verification of the following:
(1) That an
				applicant has completed the Application for Help with Medicare Prescription
				Drug Plan Costs and received a determination from the Social Security
				Administration. If the applicant is confident they will be denied low-income
				subsidy due to resources, HoosierRx may make the income and resource
				determination.
(2) Of an
				applicant's enrollment in a Medicare Part D plan that has contracted with the
				IPDP to provide state benefits in coordination with Medicare Part D.
Indiana Administrative Code › Title 405 - OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES › Article 8 - INDIANA PRESCRIPTION DRUG PROGRAM MEDICARE PART D ASSISTANCE BENEFIT › Rule 4 - Application and Enrollment › Section 4-2 - Redetermination of eligibility

Current through July 10, 2024
Authority: IC
				  12-10-16-5
Affected: IC 12-10-16
Sec. 2.
IPDP shall make an annual redetermination of each member's
				  eligibility for program benefits by requesting information from member as
				  needed to make such redetermination. Members must provide program with any
				  requested documentation as needed to determine eligibility for 2007 IPDP
				  benefits.
Indiana Administrative Code › Title 405 - OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES › Article 8 - INDIANA PRESCRIPTION DRUG PROGRAM MEDICARE PART D ASSISTANCE BENEFIT › Rule 5 - Auto-Assignment to a Medicare Prescription Drug Plan › Section 5-1 - Auto-assignment

Current through July 10, 2024
Authority: IC
				  12-10-16-5
Affected: IC 12-10-16
Sec. 1.
(a) If,
				according to the Centers for Medicare and Medicaid Services, an applicant
				otherwise eligible for the Indiana prescription drug program has not selected a
				Medicare Part D plan, the program may randomly assign the member to a Medicare
				prescription drug plan that has contracted with the IPDP.
(b) The applicant will be sent a letter
				notifying them that they will have at least twenty-five (25) calendar days to
				select a Medicare prescription drug plan that has contracted with the IPDP. If
				no selection has been made within the period of not less than twenty-five (25)
				calendar days, the office may auto-assign the applicant to a Medicare
				prescription drug plan that has entered into agreement with the IPDP. An
				applicant may opt out of the auto-assignment by calling or writing the IPDP
				before the end of the twenty-five (25) calendar day period.
(c) Married couples auto-assigned by the
				office will be assigned to the same Medicare Part D plan when
				possible.
(d) Any applicant that
				has not selected a Medicare Part D plan before the end of the initial
				enrollment period, that is otherwise eligible for the program, may be
				auto-assigned to a Medicare Part D plan, before the end of the twenty-five (25)
				calendar day opt-out period.
Indiana Administrative Code › Title 405 - OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES › Article 8 - INDIANA PRESCRIPTION DRUG PROGRAM MEDICARE PART D ASSISTANCE BENEFIT › Rule 6 - Benefits › Section 6-1 - Assistance with Medicare prescription drug plan monthly premium

Current through July 10, 2024
Authority: IC
				  12-10-16-5
Affected: IC 12-10-16
Sec. 1.
(a) An
				eligible member may receive:
(1) premium
				assistance for the monthly premium cost of the:
(A) Medicare prescription drug plan;
				or
(B) Medicare-Advantage
				prescription drug plan.