Indiana Administrative Code › Title 405 - OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES › Article 10 - HEALTHY INDIANA PLAN › Rule 4 - Eligibility › Section 4-5 - Transitional medical assistance category

Current through July 10, 2024
Authority: IC 12-15-44.5-9
Affected: IC 12-15-44.5
Sec. 5.
(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 for continued HIP eligibility for Section 1931
				parent and caretaker relatives whose income from employment increases to above
				one hundred thirty-three percent (133%) of the FPL. If all other requirements
				of the program are met, these members may receive HIP coverage for an
				additional six (6) months regardless of the amount of increased income. If the
				increase does not equal more than one hundred eighty-five percent (185%) of the
				FPL, the coverage may last up to twelve (12) months as provided in this
				section. Actual childcare expenses due to employment shall be deducted from
				countable income during the transitional medical assistance period.
(c) A member in the transitional medical
				assistance category 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 lose eligibility under transitional medical assistance, and if income has
				not decreased to below one hundred percent (100%) of the FPL, shall lose
				eligibility for the plan altogether.
(d) A member who is eligible for the
				transitional medical assistance category shall respond to requests to resolve
				discrepant information, and must comply with annual redetermination if it comes
				due during the transitional medical assistance period in order to maintain
				eligibility for such assistance category under the plan, but there shall not be
				any additional reporting required from these members.
(e) A member who no longer meets the
				parent/caretaker requirement due to having no remaining dependents in the home,
				or who does not maintain employment and shows no good cause for the job loss,
				shall no longer be eligible for the transitional medical assistance category.
				If the member is not eligible without the protection of the transitional
				medical assistance category, the member shall be terminated from the plan. A
				member whose income increases to over one hundred eighty-five percent (185%) of
				the FPL shall no longer be eligible for the transitional medical assistance
				category and shall be terminated from the plan at the end of month six (6) or
				at the time of the increase, whichever is later. Members terminated for reasons
				other than nonpayment of required POWER account 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 and shall be terminated from
				the plan altogether if countable household income remains in excess of one
				hundred and thirty-three percent (133%) of the FPL at the expiration of the
				maximum twelve (12) months of transitional medical assistance.