reglab/statecodes huggingface dataset:
Ohio Administrative Code › Title 5160:1 - Eligibility › Chapter 5160:1-3 - Medicaid for the Aged, Blind, or Disabled (ABD) › Section 5160:1-3-03.3 - Medicaid: deeming of income

Current through all regulations passed and filed through July 1, 2024
(A)
								This rule
			 describes the process for calculating the amount of income to deem from an
			 ineligible spouse, ineligible parent, or sponsor when determining eligibility
			 for medical assistance for an eligible spouse, eligible child, or sponsored
			 alien.
(1)
									When
			 an eligible spouse resides in the same household with his or her ineligible
			 spouse, or an eligible child under age eighteen resides in the same household
			 with his or her ineligible parent(s), a portion of the income and resources of
			 such spouse or parent are included in determining the eligible spouse's or
			 eligible child's financial eligibility for medical assistance for the aged,
			 blind, or disabled. For spouse-to-spouse deeming to apply, the eligible spouse
			 must be eligible based on his or her own income.
(2)
									If a sponsored
			 alien is sponsored by his or her ineligible spouse or ineligible parent(s),
			 apply spouse-to-spouse or parent-to-child deeming calculations.
(3)
									If a sponsored
			 alien has a sponsor and also has an ineligible spouse or ineligible parent(s)
			 who is not his or her sponsor, apply both sponsor-to-alien and spouse-to-spouse
			 (or parent-to-child) deeming calculations.
Ohio Administrative Code › Title 5160:1 - Eligibility › Chapter 5160:1-3 - Medicaid for the Aged, Blind, or Disabled (ABD) › Section 5160:1-3-03.4 - Medicaid: continued medicaid coverage for children who lost their eligibility for supplemental security income (SSI) due to a change in the disability determination

Current through all regulations passed and filed through July 1, 2024
Ohio Administrative Code › Title 5160:1 - Eligibility › Chapter 5160:1-3 - Medicaid for the Aged, Blind, or Disabled (ABD) › Section 5160:1-3-03.5 - Medicaid: application of income standards

Current through all regulations passed and filed through July 1, 2024
(A) The purpose of this rule is to set forth
			 the application of income standards used in medicaid eligibility determinations
			 for aged, blind, or disabled individuals.
(B) Definitions.
(1) "Income standard" means the income limit
			 above which an individual is ineligible for a given category of medicaid for
			 the aged, blind or disabled.
(2)
			 "Couple income standard" is equal to the current supplemental security income
			 (SSI) benefit rate for a couple. The updated figure is published annually by
			 the social security administration.
(3) "Individual income standard" is equal to
			 the current supplemental security income (SSI) benefit rate for an individual.
			 The updated figure is published annually by the social security administration.
Ohio Administrative Code › Title 5160:1 - Eligibility › Chapter 5160:1-3 - Medicaid for the Aged, Blind, or Disabled (ABD) › Section 5160:1-3-03.6 - Medicaid: treatment of rental income

Current through all regulations passed and filed through July 1, 2024
(A) The purpose of this rule is to describe
			 the calculation and treatment of rental income and expenses for
			 medical assistance eligibility
			 determinations.
(B)
			 Definitions.
(1) "Net rental income" means
			 gross rent less the ordinary and necessary expenses paid in the same taxable
			 year. Net rental
			 income is treated as unearned income unless the individual is in the
			 business of renting properties, in which case the income is
			 treated as earned income from self-employment.
(2) "Ordinary and necessary expenses" are
			 those expenses necessary for the production or
			 collection of rental income. In general, these
			 expenses include interest on debts, state and local taxes on real and personal
			 property, state and local taxes on motor fuel,
									 general sales taxes, and expenses for managing or
			 maintaining property.
(3) "Rent"
			 means a payment which an individual receives for the use of real or personal
			 property, such as land, housing, or
			 machinery.
Ohio Administrative Code › Title 5160:1 - Eligibility › Chapter 5160:1-3 - Medicaid for the Aged, Blind, or Disabled (ABD) › Section 5160:1-3-03.7 - Medicaid: treatment of sick pay and sick leave

Current through all regulations passed and filed through July 1, 2024
(A) The purpose of this rule is to set forth
			 the treatment of sick pay and sick leave for  eligibility for
			 medical assistance.
(B) Definitions.
(1) "Sick pay" means a payment made to or on
			 behalf of an employee by an employer or a private third party for sickness or
			 accident disability.
(2) "Sick
			 leave" means a paid absence from duty for personal or family medical reasons
			 and considered a continuation of
			 salary.
Ohio Administrative Code › Title 5160:1 - Eligibility › Chapter 5160:1-3 - Medicaid for the Aged, Blind, or Disabled (ABD) › Section 5160:1-3-03.8 - Medicaid: in-kind support and maintenance

Current through all regulations passed and filed through July 1, 2024
(A) This rule sets forth how in-kind support
			 and maintenance is valued for purposes of determining eligibility
			 for medical assistance.
(B) Definitions.
(1) "Actual value" is the dollar amount that
			 an individual paid for an item or service, or for his/her share of an item or
			 service.
(2) "Current market value"
			 is the dollar amount for which an item would sell on the local open
			 market.
(3) "Household" is a
			 personal place of residence in which individuals share common living quarters
			 and function as a single economic unit.
(4)
									"Household of
			 another income standard" is equal to two-thirds of the income standard for an
			 individual or couple as applicable.
(5) "In-kind support
			 and maintenance" is unearned income in the form of food or shelter, or
			 something that can be used to get food or shelter, that a person is given or
			 receives because someone else pays for it.
(6) "Living in
			 household of another" means that the individual does
			 not live in his/her own household as defined in paragraph (B)(7) of this
			 rule.
(7) "Living in own
			 household" means that:
(a) The individual has
			 ownership interest or life estate in the home; or,
(b) The individual is liable for payment of
			 any part of a rental charge; or,
(c) The individual pays a pro-rated share of
			 living expenses; or,
(d) The
			 individual lives in a non-institutional care situation.
(8)
			 "Non-institutional care situation" means that:
(a) The individual has been placed by a
			 public or private agency under a specific program of protective placement;
			 and,
(b) The placement is in a
			 private household that is licensed or otherwise approved by the state to
			 provide protective care; and,
(c)
			 The placing agency retains responsibility for continuing supervision of the
			 need for placement and of the services provided; and,
(d) The individual, the placing agency, or
			 some other party pays for the services provided, or has a written agreement to
			 pay for the services provided.
(9) "Presumed maximum
			 value" is one-third the value of the individual
									income standard, as set forth in rule 5160:1-3-03.5
			 of the Administrative Code, plus twenty dollars.
(10) "Public
			 assistance household" is a household in which all individuals receive some type
			 of public income-maintenance payments, including but not limited to Ohio works
			 first (OWF), supplemental security income (SSI), disaster relief and emergency
			 assistance, or state or local government assistance programs based on
			 need.
(11)
									"Shelter" means living quarters for an individual in the
			 individual's permanent living arrangement.
(12) "Shelter
			 costs" means  rent, mortgage payments, real property taxes,
			 heating fuel, gas, electricity, water, sewerage, and garbage collection
			 services.
Ohio Administrative Code › Title 5160:1 - Eligibility › Chapter 5160:1-3 - Medicaid for the Aged, Blind, or Disabled (ABD) › Section 5160:1-3-03.10 - Medicaid: retirement funds

Current through all regulations passed and filed through July 1, 2024
(A)
								This rule
			 describes how retirement funds are treated for purposes of determining medical
			 assistance eligibility.
(B)
								Definition. "Retirement funds" are plans designed to
			 provide unearned income to supplant or supplement earned income. Retirement
			 funds may include, but are not limited to such plans as: public and private
			 pension, disability, or retirement plans; defined benefit employer pension
			 plans, profit sharing pension plans, 403(b) pension plans, money purchase
			 pension plans, employee stock ownership plans, individual retirement accounts
			 (IRA); KEOGH pension plans, Roth IRAs, simplified employee pension plans
			 (SEP-IRA), and 401k pension plans; or any other pension or retirement plans
			 authorized under 401, 403, 408 of the Internal Revenue Code (IRC) as outlined
			 in 26 U.S.C. (as in effect on February 1, 2016), or any other enacted IRC
			 provisions providing for a pension or retirement plan or any other similar
			 financial vehicles administered by an individual, employer, or union. A
			 retirement fund converted into an annuity shall be considered in accordance
			 with rule 5160:1-3-05.3 of the Administrative Code.
(C)
								Retirement funds
			 treated as income.
(1)
									A retirement fund in which an individual has the legal
			 ability to receive regular guaranteed lifetime payments will be treated as a
			 source of unearned income rather than as a resource. A defined benefit employer
			 pension plan is an example of this type of retirement.
(2)
									The individual is
			 required to obtain the maximum available amount of payment from the plan. If
			 the maximum available amount of payment requires the individual's spouse to
			 consent to a waiver of the spouse's survivor benefits, the individual must
			 document a good faith attempt to obtain that consent, and whether consent was
			 obtained or refused. If consent is not obtained, the individual must elect the
			 minimum spousal survivor benefit required by the plan.
(3)
									If allowed in the
			 plan, the individual may elect a lesser payment in favor of retaining a minimum
			 survivor benefit for a child who can be documented to be blind or disabled, as
			 defined in rule
			 5160:1-3-02
			 of the Administrative Code.
(4)
									If the retirement
			 fund is determined to not be income, then the retirement fund shall be
			 evaluated as a potential resource.
Ohio Administrative Code › Title 5160:1 - Eligibility › Chapter 5160:1-3 - Medicaid for the Aged, Blind, or Disabled (ABD) › Section 5160:1-3-05.1 - Medicaid: resource requirement

Current through all regulations passed and filed through July 1, 2024
(A)
								This rule
			 describes how resources are treated for purposes of determining eligibility for
			 medical assistance.
(B)
								Definitions.
(1)
									"Countable resources" mean those resources remaining
			 after all exclusions have been applied.
(2)
									An "encumbrance"
			 means a claim, lien, charge, or liability attached to and binding on an
			 identified piece of real or personal property.
(3)
									"Equity value"
			 means the fair market value of a resource minus any encumbrance on
			 it.
(4)
									"Fair market value" of a resource means the going
			 price, for which real or personal property can reasonably be expected to sell
			 on the open market, in the particular geographic area involved.
(5)
									"Geographic area"
			 means the area covered by radio, television, newspaper, and other media serving
			 the area where the individual lives and where the property is
			 located.
(6)
									"Personal property" means any property that is not real
			 property. The term includes, but is not limited to, such things as cash,
			 jewelry, household goods, tools, life insurance policies, automobiles,
			 promissory notes, etc.
(7)
									"Real property" means land, including buildings or
			 immovable objects, attached permanently to the land.
(8)
									"Resources" is
			 defined in rule
			 5160:1-1-01
			 of the Administrative Code.
(9)
									"Resource limit"
			 means the maximum combined value of all resources an individual can have an
			 ownership interest in and still qualify for medical assistance.
(a)
										For an
			 individual, the resource limit is two thousand dollars.
(b)
										For a married
			 couple, whether both are eligible or one is ineligible, the resource limit is
			 three thousand dollars.
(c)
										A child living with a parent is considered to be an
			 individual and has a resource limit of two thousand dollars.
(10)
									"Trust" is defined in rule 5160:1-3-05.2 of the
			 Administrative Code.
Ohio Administrative Code › Title 5160:1 - Eligibility › Chapter 5160:1-3 - Medicaid for the Aged, Blind, or Disabled (ABD) › Section 5160:1-3-05.3 - Medicaid: annuities

Current through all regulations passed and filed through July 1, 2024
(A)
								This rule
			 describes the treatment of annuities for the purposes of determining
			 eligibility for medical assistance.
(B)Definition. An
			 "annuity" provides fixed, periodic payments, either for life or a term of
			 years. When an individual purchases an annuity, he or she generally pays the
			 entity issuing the annuity a lump sum of money, in return for which the issuing
			 entity promises regular payments in a specified amount to the individual or
			 designated beneficiary. These payments may continue for a fixed period of time
			 or for the lifetime of the individual or designated beneficiary. The annuity
			 typically contains a remainder clause under which, if the annuitant dies, the
			 contracting entity converts whatever is remaining in the annuity into a lump
			 sum and pays it to a designated beneficiary.
(C)
								Treatment of
			 annunities in the determination of eligibility for medical assistance.
(1)
									Any resource
			 meeting the definition of an annuity in paragraph (B) of this rule shall be
			 considered an excluded resource.
(2)
									Any payments from
			 an annuity shall be considered as unearned income to the individual or
			 designated beneficiary.
Replaces: 5160:1-3- 05.3
Ohio Administrative Code › Title 5160:1 - Eligibility › Chapter 5160:1-3 - Medicaid for the Aged, Blind, or Disabled (ABD) › Section 5160:1-3-05.4 - Medicaid: cash and checking and savings accounts and time deposits

Current through all regulations passed and filed through July 1, 2024
(A) This rule
			 describes the treatment of cash, checking and savings accounts, and time
			 deposits for purposes of determining eligibility for medical
			 assistance.
(B) Definitions.
(1) "Cash" means money on hand or available
			 in the form of currency or coins. Foreign currency or coins are cash to the
			 extent that they can be exchanged for U.S. currency.
(a) Monthly income is not counted when
			 evaluating cash on hand.
(b) The
			 individual's statement of actual cash on hand is accepted without
			 verification.
Ohio Administrative Code › Title 5160:1 - Eligibility › Chapter 5160:1-3 - Medicaid for the Aged, Blind, or Disabled (ABD) › Section 5160:1-3-05.5 - Medicaid: promissory notes, property agreements, and loans

Current through all regulations passed and filed through July 1, 2024
(A)
								This rule describes the treatment of promissory notes,
			 property agreements, and loans for purposes of determining eligibility for
			 medical assistance.
(B)
								Definitions.
(1)
									"Promissory note" means a written, unconditional
			 promise signed by a person to pay a specified sum of money at a specified time,
			 or on demand, to the person, corporation, or institution named on the note. It
			 may be given in return for goods, money loaned, or services rendered. A
			 promissory note making periodic payments is not considered an
			 annuity.
(2)
									"Property agreement" means a pledge or security of
			 particular property for the payment of a debt or the performance of some other
			 obligation within a specified period.
(a)
										Property
			 agreements on real estate generally are referred to as mortgages but also may
			 be called real estate or land contracts, contracts for deed, deeds of trust,
			 etc.
(b)
										Personal property agreements (e.g., pledges of crops,
			 fixtures, inventory, etc.) are commonly known as chattel
			 mortgages.
Ohio Administrative Code › Title 5160:1 - Eligibility › Chapter 5160:1-3 - Medicaid for the Aged, Blind, or Disabled (ABD) › Section 5160:1-3-05.6 - Medicaid: burial funds and contracts

Current through all regulations passed and filed through July 1, 2024
(A) This rule describes the treatment of
			 burial funds and burial contracts for purposes of determining eligibility for
			 medical assistance.
(B)
			 Definitions.
(1) "Burial funds" are revocable
			 burial contracts, revocable burial trusts, other revocable burial arrangements
			 (including the value of certain installment contract for burial spaces), cash,
			 financial accounts (checking or savings accounts), or other financial
			 instruments with a definite cash value (e.g. stocks, bonds, etc.).
(2)
			 "Prepaid burial contract" means an agreement whereby the buyer pays in advance
			 for a burial that the seller agrees to furnish upon the death of the buyer or
			 other designated individual.
Ohio Administrative Code › Title 5160:1 - Eligibility › Chapter 5160:1-3 - Medicaid for the Aged, Blind, or Disabled (ABD) › Section 5160:1-3-05.7 - Medicaid: burial spaces

Current through all regulations passed and filed through July 1, 2024
(A)
								This rule
			 describes the treatment of burial spaces for the purposes of determining
			 eligibility for medical assistance.
(B)
								Definitions.
(1)
									"Agreement," for the purpose of this rule, means a
			 contract with a burial provider for a burial space held for the individual or a
			 member of the individual's immediate family.
(2)
									"Burial space,"
			 means a burial plot, gravesite, crypt, mausoleum, casket, urn, niche, or other
			 repository customarily and traditionally used for the deceased's bodily
			 remains. The term also includes a contract for care and maintenance of the
			 gravesite, sometimes referred to as an endowment or perpetual care and
			 necessary and reasonable improvements or additions to such spaces, including
			 but not limited to vaults, headstones, markers, or plaques, burial containers
			 (e.g., for caskets) and arrangements for the opening and closing of the
			 gravesite.
(3)
									"Immediate family" includes the individual's:
(a)
										Parents,
			 including adoptive parents;
(b)
										Minor or adult
			 children, including adoptive and stepchildren;
(c)
										Siblings,
			 including adoptive and stepsiblings; or
(d)
										Spouses of
			 immediate family if the marriage is in effect at the time of determination or
			 renewal of eligibility for medical assistance.
Ohio Administrative Code › Title 5160:1 - Eligibility › Chapter 5160:1-3 - Medicaid for the Aged, Blind, or Disabled (ABD) › Section 5160:1-3-05.8 - Medicaid: lump-sum payments

Current through all regulations passed and filed through July 1, 2024
(A) This rule describes the treatment of
			 lump-sum payments for purposes of determining eligibility for medical
			 assistance.
(B) Definition.
			 "Lump-sum payment" means income which is accrued over two or more months or a
			 money payment which is not related to any time period, such as a death benefit
			 or inheritance.
(C) An anticipated
			 nonrecurring lump-sum payment is considered unearned income unless otherwise
			 excluded. It is unearned income in the month received and a countable resource
			 in the month following the month of receipt. The following are some types of
			 anticipated lump-sum payments that are considered unearned income:
(1) Gifts, prizes, or awards.
(2) Retirement or pension funds.
(3) Judgments and out-of-court
			 settlements.
(4) Proceeds received
			 as the beneficiary of a life insurance policy, including social security
			 lump-sum death benefits.
(5)
			 Workers compensation payments when received as a lump-sum.
Ohio Administrative Code › Title 5160:1 - Eligibility › Chapter 5160:1-3 - Medicaid for the Aged, Blind, or Disabled (ABD) › Section 5160:1-3-05.9 - Medicaid: dividends and interest

Current through all regulations passed and filed through July 1, 2024
(A)
								This rule
			 describes the treatment of dividends and interest for the purposes of
			 determining eligibility for medical assistance.
(B)
								Definitions.
			 "Dividends" and "interest", for the purpose of this rule, are returns on
			 financial institution accounts. A cash gift or incentive payment to open an
			 account is considered interest.
(C)
								If the resource
			 that produced the dividends or interest is:
(1)
									A countable
			 resource, the dividends and interest are excluded.
(2)
									Excluded under a
			 federal statute other than the Social Security Act, the dividends and interest
			 are excluded.
(3)
									Excluded under section 1613(a) of the Social Security
			 Act as described in rule 5160:1-3-05.14 of the Administrative Code, the
			 dividends and interest may or may not be excluded, depending on the specific
			 resource.
Replaces: 5160:1-3- 05.9
Ohio Administrative Code › Title 5160:1 - Eligibility › Chapter 5160:1-3 - Medicaid for the Aged, Blind, or Disabled (ABD) › Section 5160:1-3-05.10 - Medicaid: household goods and personal effects as resources

Current through all regulations passed and filed through July 1, 2024
(A)
								This rule describes the treatment of household goods
			 and personal effects for the purposes of determining eligibility for medical
			 assistance.
(B)
								Definitions.
(1)
									"Encumbrance"
			 means a claim, lien, charge, or liability attached to and binding on an
			 identified piece of real or personal property.
(2)
									"Household
			 goods", for the purpose of this rule, are all personal property customarily
			 found in or near the home and used on a regular basis in connection with the
			 maintenance, use and occupancy of the premises. This encompasses items
			 necessary for an adequate standard of sustenance, accommodation, comfort,
			 information and entertainment of occupants and guests. Such items include
			 furniture, household appliances, carpets, dishes, cooking and eating utensils,
			 televisions and personal computers.
(3)
									"Personal
			 effects, for the purpose of this rule, are other personal property normally
			 held and recognized as incidental items intended for personal use by one or
			 more household members. Such items include clothing, personal jewelry, pets,
			 personal care items musical instruments, books, or items of cultural or
			 religious significance.
Ohio Administrative Code › Title 5160:1 - Eligibility › Chapter 5160:1-3 - Medicaid for the Aged, Blind, or Disabled (ABD) › Section 5160:1-3-05.11 - Medicaid: automobiles and other modes of transportation as resources

Current through all regulations passed and filed through July 1, 2024
(A) This rule
			 describes the treatment of automobiles and other modes of transportation for
			 purposes of determining eligibility for medical assistance.
(B) Definition. "Automobile", for the purpose
			 of this rule, means any vehicle used for transportation. It can include, in
			 addition to cars and trucks: motorcycles, boats,
			 snowmobiles, animal-drawn vehicles, and  animals.
(C) One automobile is excluded for the
			 individual,
								 regardless of value, if a member of the
			 individual's household uses the automobile for transportation.
(1) For
			 the purpose of determining the community
			 spouse resource allowance for couples when one spouse is institutionalized, one
			 automobile is considered totally excluded, regardless of its use and value in
			 accordance with rule 5160:1-6-04 of the Administrative
			 Code.
(2) If an automobile is not
			 excluded, count the equity value of the automobile as a resource.
(3) Any automobile an individual owns in
			 addition to the one wholly excluded and which cannot be excluded under another
			 rule (e.g., property essential for selfsupport) is a resource in the amount of
			 its equity value.
(4) If one of two
			 automobiles can be excluded because of one of the reasons
			 listed above, and the other is a countable resource, the exclusion applies to
			 the automobile with the greater equity value regardless of
			 which automobile is actually used.
(5) The equity value for all additional
			 automobiles, regardless of the type of vehicle , is counted as a
			 resource.
(6) The equity value for
			 all vehicles that are not used for transportation (e.g., pleasure boats,
			 snowmobiles, etc.) or excluded under another rule (e.g., necessary for
			 self-employment) is counted as a resource. These vehicles are considered
			 countable personal effects.
Ohio Administrative Code › Title 5160:1 - Eligibility › Chapter 5160:1-3 - Medicaid for the Aged, Blind, or Disabled (ABD) › Section 5160:1-3-05.13 - Medicaid: treatment of the home

Current through all regulations passed and filed through July 1, 2024
(A) This rule
			 describes the treatment of an individual's home for purposes of determining
			 eligibility for medical assistance.
(B) Definitions.
(1) "Home," for the
			 purpose of this rule, means any property in which an individual has an
			 ownership interest  and which serves as
			 the individual's principal place of residence. Home includes the structures and
			 land appertaining to the home property. Appertaining land must adjoin the land
			 on which the home property is located and must not be separated by intervening
			 land property owned by others.
(2)
			 "Principal place of residence" means the dwelling considered to be
									the individual's established or
			 principal home and to which, when absent, the individual intends to return.
			 Principal place of residence can be real or personal property, fixed or mobile,
			 and located on land or water.
(a) Only one
			 dwelling may be established as the principal place of
			 residence.
(b) The administrative
			 agency must obtain a signed statement, declaring the principal place of
			 residence, when there is an indication the individual resides in or has
			 ownership of more than one place.
Ohio Administrative Code › Title 5160:1 - Eligibility › Chapter 5160:1-3 - Medicaid for the Aged, Blind, or Disabled (ABD) › Section 5160:1-3-05.16 - Medicaid: home replacement exclusion

Current through all regulations passed and filed through July 1, 2024
(A) This rule describes the application of
			 the home replacement exclusion for purposes of determining eligibility for
			 medical assistance. When the home is being replaced due to loss or damage
			 resulting from a disaster, refer to rule 5160:1-3-05.14 of the Administrative
			 Code.
(B) Definitions.
(1) "Proceeds" mean the net payments received
			 by the seller after satisfaction of all encumbrances and sale expenses.
(2) "Sale expenses" mean all expenses that
			 must be paid by the seller in connection with the sale of the home, including
			 but not limited to broker fees, commissions, legal fees, mortgage-related fees
			 such as points paid by the seller, inspection and settlement fees, and transfer
			 and other accrued taxes paid by the seller.
Ohio Administrative Code › Title 5160:1 - Eligibility › Chapter 5160:1-3 - Medicaid for the Aged, Blind, or Disabled (ABD) › Section 5160:1-3-05.17 - Medicaid: life estates

Current through all regulations passed and filed through July 1, 2024
(A) This rule describes the treatment of life
			 estates for the purposes of determining eligibility for medical
			 assistance.
(B) Definitions.
(1) "Date of signature" is the date on which
			 an individual with authority to transfer the physical property actually signed
			 the life estate instrument.
(2)
									"Individual," for
			 the purpose of this rule, has the same meaning as in rule
			 5160:1-1-01 of the
			 Administrative Code.
(3) "Life estate" means
			 an ownership interest in physical property
			 wherein one person holds the right to possess, use, and obtain profits from the
			 physical property for the extent of the
			 person's lifetime, while another person holds the actual ownership
			 interest in the physical property.
(a) A life estate is a form of legal
			 ownership.
(b)
										A life
			 estate is usually created through an instrument, such as a deed,
										a will, or by operation
			 of law.
(c) A life estate
			 instrument often identifies remaindermen who will take possession of the
			 physical property upon the expiration of the life
			 estate.
(d) A life estate owner, also known as a life tenant, owns
			 a life
			 estate property only for the duration of time
			 specified
										in the life estate instrument. Only the individual
			 who
										owns
			 the life estate can sell  interest in the life estate. The life
			 estate owner cannot take any action concerning the interest of the
			 remainderman.
(4) "Recording date"
			 means the date that the life estate deed is
			 recorded with the county auditor, county recorder, or other appropriate
			 government agency charged with the responsibility for recording real estate
			 transfers and titles.
(5) A "remainderman"
			 is a person who inherits or is entitled to inherit
			 physical property in a life estate. A remainderman has an ownership
			 interest in the physical property but normally does not have the right to
			 possess and use the property until the
			 expiration of the life estate.
Ohio Administrative Code › Title 5160:1 - Eligibility › Chapter 5160:1-3 - Medicaid for the Aged, Blind, or Disabled (ABD) › Section 5160:1-3-05.18 - Medicaid: stocks, mutual funds, and bonds

Current through all regulations passed and filed through July 1, 2024
(A)
								This rule
			 describes the treatment of stocks, mutual funds, and bonds for purposes of
			 determining eligibility for medical assistance.
(B)
								Stocks held by an
			 individual, including preferred stocks, warrants and rights, and stock option
			 purchases.
(1)
									Stock shares represent ownership in a business corporation.
			 Their value shifts with demand and may fluctuate widely.
(2)
									The current
			 market value of publicly traded stock as of the first moment of a given month
			 is its closing price on the last business day of the preceding month. The stock
			 closing price, on a given day, can usually be found in the next day's regulator
			 or financial newspaper. The value of over-the-counter stocks are shown on a
			 "bid" and "asked" basis. The bid price is used to determine the stock's
			 value.
(a)
										If
			 the closing or bid price of a stock is not shown, a local securities firm must
			 determine its value.
(b)
										The stock of some corporations not publicly traded is
			 held within close groups and traded very infrequently. The sale of such stock
			 is often handled privately and subject to restrictions. The burden of proof for
			 establishing the value of this kind of stock is on the individual. The
			 preferred evidence is a letter or other written statement from the firm's
			 accountants giving their best estimate of the stock's value and the basis for
			 the estimate, and can include the most recent sale, the most recent offer from
			 outsiders, the current market value of assets less debts on them, cessation of
			 activity and sale of assets, and bankruptcy.
(3)
									The county
			 prosecutor or the administrative agency's legal staff shall be consulted for
			 assistance in determining the value of the stock when the verification of the
			 current value of the stock of a closely held corporation is questionable,
			 including when there are indications that the extent of an individual's
			 ownership is being manipulated to reduce the value of the stock as a countable
			 resource.
(4)
									If the ownership of the stock is shared (i.e., more
			 than one name is on the face of the stock certificate), each owner owns an
			 equal share of the value of the stock.
(5)
									Shares of stock
			 in an Alaskan native regional or village corporation, as defined in
			 43 U.S.C.
			 1601-
			 1624
			 (as in effect on February 1, 2016), are excluded from
			 resources.
Ohio Administrative Code › Title 5160:1 - Eligibility › Chapter 5160:1-3 - Medicaid for the Aged, Blind, or Disabled (ABD) › Section 5160:1-3-05.19 - Medicaid: real or personal property essential to self-support

Current through all regulations passed and filed through July 1, 2024
(A) This rule
			 describes exclusions when real or personal property is essential to an
			 individual's means of self-support.
(B) Definition.
(1) "Basic daily living needs", for the
			 purpose of this rule, means any food, basic clothing, basic shelter, and any
			 medical care that are not provided by medicaid. Items for entertainment or
			 leisure are not basic daily living needs.
(2) "Maximum allowable equity" means an
			 individual's equity in income-producing property, up to a maximum of six
			 thousand dollars.
Ohio Administrative Code › Title 5160:1 - Eligibility › Chapter 5160:1-3 - Medicaid for the Aged, Blind, or Disabled (ABD) › Section 5160:1-3-06 - Medicaid: social security administration reporting alleged transfer of resources by supplemental security income (SSI) applicants to the Ohio department of job and family services (ODJFS)

Current through all regulations passed and filed through July 1, 2024
Ohio Administrative Code › Title 5160:1 - Eligibility › Chapter 5160:1-3 - Medicaid for the Aged, Blind, or Disabled (ABD) › Section 5160:1-3-07.1 - Medicaid: social security administration reporting alleged transfer of resources by supplemental security income (SSI) applicants to the Ohio department of medicaid (ODM)

Current through all regulations passed and filed through July 1, 2024
Ohio Administrative Code › Title 5160:1 - Eligibility › Chapter 5160:1-4 - Medicaid for the MAGI Covered Groups › Section 5160:1-4-02 - MAGI-based medicaid: coverage for children younger than nineteen years of age

Current through all regulations passed and filed through July 1, 2024
(A) This rule describes
			 
								the
			 eligibility criteria for a child from birth until the individual reaches
			  nineteen years
			 of age in accordance with
			 42 C.F.R.
			 435.118 (as in effect
			 October
			 1, 2020) for applications for medical assistance.
(B) Definition. "Child"  means an individual younger than nineteen years of
			 age.
(C) Eligibility criteria
			 for coverage because a newborn child was born to a medicaid-eligible woman
			 (deemed newborn). In accordance with
			 42 C.F.R.
			 435.117 (as in effect
			 October
			 1, 2020), a child is automatically eligible for
			 medical
			 assistance as of the child's date of birth, and remains eligible until
			 the child reaches the age of one, provided the birth mother has applied for,
			 been determined eligible for, and is receiving medical
			 assistance on the date of the child's birth.
(1) Coverage under this paragraph also
			 applies to newborns under the following circumstances:
(a) When labor and delivery services were
			 furnished prior to the date of application and the birth mother's medicaid
			 eligibility is based on retroactive coverage in accordance with
			 42 C.F.R. 435.915
			 (as in effect October 1, 2020).
(b)
										When the birth
			 mother is receiving alien emergency medical assistance (AEMA) in accordance
			 with rule
			 5160:1-5-06
			 of the Administrative Code.
(c)
										When the
			 birth mother is residing in a public institution and is:
(i) Restricted from payment of services as
			 referenced in rule
			 5160:1-1-03
			 of the Administrative Code; and
(ii) Within twelve months
			 of the
			 date of her most recent medicaid application or renewal.
(d)
										When the birth
			 mother is in the custody of a public children services agency (PCSA) or private
			 child placing agency (PCPA).
(e)
										When the
			 birth mother is in receipt of adoption or foster care assistance under Title
			 IV-E.
(f)
										When the
			 birth mother is in receipt of state or federal adoption assistance.
(g) When the birth mother loses medicaid
			 eligibility after the birth of the newborn.
(h) When the birth mother is no longer a
			 member of the newborn's household at any time prior to the newborn reaching the
			 age of one.
Ohio Administrative Code › Title 5160:1 - Eligibility › Chapter 5160:1-4 - Medicaid for the MAGI Covered Groups › Section 5160:1-4-03 - MAGI-based medicaid: coverage for Ribicoff and former foster care children

Current through all regulations passed and filed through July 1, 2024
(A) This rule describes the eligibility
			 criteria for applications for medical assistance for individuals:
(1) Who are nineteen or twenty years of age;
			 or
(2) Who aged out of foster care,
			 are younger than twenty-six years of age, and are not otherwise eligible for a
			 mandatory category of coverage under the medicaid state plan. An individual who
			 is eligible for coverage both as a former foster care child and under the
			 coverage described in section 1902(a)(10)(A)(i)(VIII) of the Social Security
			 Act (as in effect October 1, 
									2022) shall be placed in the former foster care
			 eligibility category.
Ohio Administrative Code › Title 5160:1 - Eligibility › Chapter 5160:1-4 - Medicaid for the MAGI Covered Groups › Section 5160:1-4-04 - MAGI-based medicaid: coverage for pregnant individuals

Current through all regulations passed and filed through July 1, 2024
(A) This rule
			 describes eligibility for pregnant individuals as described in
			 42 C.F.R.
			 435.116 (as in effect on October 1,
			 2023) for
			 applications for medical assistance.
(B) Eligibility criteria for coverage because
			 an individual is pregnant.
(1) The individual
			 must be female and pregnant.
(2) A
			 statement from the individual, a physician, or managed care
			 organization
			 (MCO) is sufficient verification of pregnancy, unless the administrative
			 agency has information contradicting the individual's statement.
			 Self-attestation of pregnancy is acceptable unless
			 available information conflicts with the attestation or the woman is pregnant
			 with more than one fetus.
(3)
			 The individual's household income must not exceed two hundred per cent of the
			 federal poverty level for the family size. For the purpose of this rule, family
			 size includes the number of fetuses.
(4) An individual who is in her postpartum
			 period, as defined in rule
			 5160:1-1-01 of the
			 Administrative Code, is also eligible under the criteria described in this
			 rule.
Ohio Administrative Code › Title 5160:1 - Eligibility › Chapter 5160:1-4 - Medicaid for the MAGI Covered Groups › Section 5160:1-4-05 - MAGI-based medicaid: coverage for a parent or caretaker relative residing with a child

Current through all regulations passed and filed through July 1, 2024
(A) This rule describes the eligibility
			 requirements for parents and caretaker relatives residing with children as
			 described in 42 C.F.R.
			 435.110 (as in effect October 1,
			 2023),
			 transitional medical assistance as described in section 1925 of the Social
			 Security Act (as in effect October 1, 2023), and
			 extended medical assistance as described in section 1931 of the Social Security
			 Act (as in effect October 1, 2023).
(B)
			 Eligibility criteria for coverage because an individual is a parent or
			 caretaker relative residing with a child.
(1)
			 The individual must be residing with a dependent child under the age of
			 eighteen. An individual is considered to be residing with the child even if the
			 child is temporarily absent with the intent to return home.
(2) The individual must be the child's parent
			 or caretaker relative, or a spouse residing with the child's parent or
			 caretaker relative.
(3) The
			 individual's household income must not exceed ninety per cent of the federal
			 poverty level for the family size.
Ohio Administrative Code › Title 5160:1 - Eligibility › Chapter 5160:1-4 - Medicaid for the MAGI Covered Groups › Section 5160:1-4-06 - Medicaid: coverage for individuals in receipt of adoption or foster care assistance

Current through all regulations passed and filed through July 1, 2024
(A) This rule describes eligibility criteria
			 for medical assistance for individuals who are in receipt of:
(1) Adoption or foster care assistance under
			 Title IV-E of the Social Security Act (as in effect October 1,
			 2023);
			 or
(2) State foster care
			 assistance; or
(3) State adoption
			 assistance subsidies; or
(4) State
			 adoption assistance in accordance with
			 42 C.F.R.
			 435.227 (as in effect October 1,
			 2023).
Ohio Administrative Code › Title 5160:1 - Eligibility › Chapter 5160:1-5 - Medicaid for Other Covered Groups › Section 5160:1-5-01 - Medicaid: the residential state supplement (RSS) program

Current through all regulations passed and filed through July 1, 2024
(A) RSS provides
			 cash assistance to aged, blind, or disabled adults who are eligible for medical
			 assistance and who have increased needs due to a medical condition which is not
			 severe enough to require institutionalization. The RSS cash payment is used
			 together with the individual's income to help prevent institutionalization and
			 to deinstitutionalize those aged, blind, or disabled adults who have been
			 placed in longterm care facilities and who can return to the community through
			 an alternative living arrangement.
(B) Definitions.
(1) "Countable income," for the purpose of
			 this rule, means income remaining after exclusions.
(2) "Income standard," for the purpose of
			 this rule, means the aggregate of the allowable fee standard and the personal
			 needs allowance as defined in rule
			 5122-36-05 of the Administrative
			 Code.
(3) "Individual," for the
			 purpose of this rule, means a person who is applying for or receiving RSS
			 benefits.
(4) "Institutional
			 placement," for the purpose of this rule, means placement in a public medical
			 institution, a hospital which has a provider agreement with the Ohio department
			 of medicaid, or a Title XIX certified long-term care facility (LTCF).
(5) "OhioMHAS" means the Ohio department of
			 mental health and addiction services .
(6) "RSS
			 living arrangement" means an arrangement listed in paragraph (A) of rule
			 5122-36-02 of the Administrative
			 Code.
(7) "RSS" means the
			 residential state supplement program implemented under section
			 5119.41 of the Revised
			 Code.
(8) "RSS protected date," for
			 the purpose of this rule, means the signature date on a completed "Residential
			 State Supplement (RSS) Referral for Enrollment" (ODM 07120 rev. 11/2020) or an
			 electronic equivalent, or a "Residential State Supplement (RSS) Program
			 Application" (DMHAS-7046 rev. 01/18).
(9) "Temporary institutional placement," for
			 the purpose of this rule, means placement, not to exceed ninety days, in a
			 public medical institution, a hospital which has a provider agreement with the
			 Ohio department of medicaid, or a Title XIX certified long-term care facility
			 (LTCF).
Ohio Administrative Code › Title 5160:1 - Eligibility › Chapter 5160:1-5 - Medicaid for Other Covered Groups › Section 5160:1-5-02 - Medicaid: breast and cervical cancer project (BCCP)

Current through all regulations passed and filed through July 1, 2024
(A) This rule
			 describes the medicaid breast and cervical cancer
			 project .
(B) The rules in Chapter 5160:1-5 of the
			 Administrative Code set forth the eligibility requirements for participation in
			 the breast and cervical cancer project. The Breast and Cervical Cancer
			 Prevention and Treatment Act of 2000 (BCCPTA), in accordance with
			 Pub.
			 L. No. 106-354 and
			 42 U.S.C.
			 1396a(a)(10)(A)(ii) (as in
			 effect on October 1, 2016), authorizes
			 an optional category of medicaid to provide full medicaid benefits to certain
			 individuals who need treatment for breast or cervical cancer, breast or
			 cervical pre-cancerous conditions, and/or breast or cervical early stage
			 cancer. The goals of the BCCPTA are as follows:
(1) To improve access to needed breast and
			 cervical cancer treatment for uninsured individuals identified under the
			 national breast and cervical cancer early detection program as needing such
			 treatment;
(2) To facilitate the
			 prompt enrollment in medicaid and immediate access to services for individuals
			 who are in need of treatment for breast or cervical cancer;
(3) To ensure that needed treatment begins as
			 early as possible; and
(4) To
			 coordinate activities between medicaid and public health agencies, including
			 but not limited to application procedures and case management.
Ohio Administrative Code › Title 5160:1 - Eligibility › Chapter 5160:1-5 - Medicaid for Other Covered Groups › Section 5160:1-5-02.2 - Medicaid: breast and cervical cancer project (BCCP): eligibility requirements

Current through all regulations passed and filed through July 1, 2024
(A) This rule describes the eligibility
			 criteria for BCCP medicaid.
(B) An
			 individual shall meet all of the following criteria to be eligible for BCCP
			 medicaid:
(1) Be screened for breast or
			 cervical cancer under the national breast and cervical cancer early detection
			 program (NBCCEDP).
(a) An individual is not
			 required to obtain screening for both breast and cervical cancer as a condition
			 of eligibility for participation in the NBCCEDCP.
(b) Individuals screened for breast or
			 cervical cancer under the NBCCEDP in a state other than Ohio must be determined
			 eligible for the Ohio department of health (ODH) BCCP and must utilize
			 the ODH BCCP case management services and Ohio 's BCCP medicaid application
			 process as outlined in rule 5160:1-5-02.4 of the Administrative Code.
Ohio Administrative Code › Title 5160:1 - Eligibility › Chapter 5160:1-5 - Medicaid for Other Covered Groups › Section 5160:1-5-02.4 - Medicaid: breast and cervical cancer project (BCCP): application and renewal process

Current through all regulations passed and filed through July 1, 2024
(A) This rule describes the application and
			 renewal process for the breast and cervical cancer
			 project (BCCP).
(B) The BCCP
			 medicaid application and renewal process shall:
(1) Be coordinated between Ohio department of
			 medicaid (ODM), Ohio department of health (ODH) BCCP, and ODH BCCP designated
			 local agencies and/or subgrantees,
(2) Be coordinated with ODH BCCP case
			 management services, and
(3)
			 Support the goals of the Breast and Cervical Cancer Prevention and Treatment
			 Act of 2000 (BCCPTA), identified in rule
			 5160:1-5-02
			 of the Administrative Code.
Ohio Administrative Code › Title 5160:1 - Eligibility › Chapter 5160:1-5 - Medicaid for Other Covered Groups › Section 5160:1-5-06 - Medicaid: non-citizen emergency medical assistance (NCEMA)

Current through all regulations passed and filed through July 1, 2024
(A)
								In accordance
			 with 42 U.S.C.
			 1396b(v), this rule
			 describes eligibility criteria for coverage of the treatment of an emergency medical condition for
			 certain individuals who do not meet the medicaid citizenship or satisfactory
			 immigration status requirements described in rule
			 5160:1-2-11 or
			 5160:1-2-12 of the
			 Administrative Code.
(B)
			 Definition. "Emergency medical condition," for the purpose of
			 this rule, means a medical condition with a sudden onset:
(1) Manifesting itself by acute symptoms of
			 sufficient severity (including severe pain) such that the absence of immediate
			 medical attention could reasonably be expected to result in:
(a) Placing the patient's health in serious
			 jeopardy; or
(b) Serious impairment to bodily functions;
			 or
(c) Serious dysfunction of any
			 bodily organ or part.