5101:1-40-20 Medicaid: low-income families, children, and pregnant women budgeting.

(A) This rule describes the budget methodology for income eligibility under Chapter 5101:1-40 of the Administrative Code.

(B) Definitions:

(1) "Full-time care" means at least twenty-five hours of care per week.

(2) "Part-time care" means less than twenty-five hours of care per week.

(C) The individual is income-eligible for medicaid if any of these conditions apply:

(1) The individual is eligible for, or deemed eligible for, Ohio works first (OWF) as described in Chapter 5101:1-23 of the Administrative Code.

(2) The individual meets the requirements of rule 5101:1-40-02.4 of the Administrative Code.

(3) The individual meets the requirements of paragraph (D) of this rule.

(D) If the individual is not eligible under paragraph (C)(1) or (C)(2) of this rule, determine the net countable family income.

(1) Total the individual's gross, non-exempt income.

(2) Allocate income of a step-parent, parent of a minor parent, spouse of a specified relative, or non-qualified alien parent as described in rule 5101:1-38-02.3 of the Administrative Code, who is living with the individual, but is not a member of the covered group.

(a) From the step-parent, parent of a minor parent, spouse of a specified relative, or non-qualified alien parent's income, deduct the following:

(i) The first ninety dollars of the gross earned income.

(ii) An amount equal to the allocation allowance standard, in accordance with Chapter 5101:1-23 of the Administrative Code, for the step-parent, parent of a minor parent, spouse of a specified relative, or a non-qualified alien parent and any other individuals living with but not members of the covered group, who are or could be claimed by the stepparent, parent of a minor parent, spouse of a specified relative, or non-qualified alien parent as dependents.

(iii) The amount of verifiable payments made to those who are or could be claimed by the step-parent, parent of a minor parent, spouse of a specified relative, or non-qualified alien parent, as dependents for federal personal income tax liability, but are not living in the home.

(iv) The amount of alimony or child support payments made for those not living in the home.

(b) The remaining amount of earned and unearned income is allocated to the individual as unearned income.

(3) Apply the income exemptions and disregards described in rule 5101:1-38-01.9 of the Administrative Code, and

(4) Apply the following additional exemptions:

(a) The first fifty dollars of court ordered child support received by the covered group.

(b) Court ordered child support and alimony payments made to individuals not living in the household unless already deducted in the allocation budget from paragraph (D)(2) of this rule.

(c) Earned income of a child who is a full-time student as defined by the educational facility, for up to six months per calendar year, and

(5) Disregard from the earned income of each employed covered group member:

(a) Up to ninety dollars for each employed covered group member.

(b) Out of pocket dependent care costs paid to an individual who is not a member of the covered group for a dependent child or incapacitated adult, up to but not exceeding:

(i) Two hundred dollars per infant under two years of age in full-time care.

(ii) One hundred seventy-five dollars per child over two years of age, or incapacitated adult, in full-time care.

(iii) One hundred twenty dollars per child or incapacitated adult in part-time care.

(6) Earned income disregard penalties. The disregards of earned income do not apply if:

(a) An individual terminated employment or reduced the earned income without good cause within the preceding month.

(b) An individual refused a bona fide offer of employment within the preceding month without good cause.

(c) An individual failed to timely report income in accordance with rule 5101:1-38-01.2 of the Administrative Code, without good cause.

(7) Income remaining is the net countable family income. Compare to the appropriate federal poverty level for the covered group size, as described in Chapter 5101:1-40 of the Administrative Code.

Replaces: 5101:1-40- 08.1, 5101:1-40-20, 5101:1-40- 20.3, 5101:1-40- 20.4, 5101:1-40- 20.5, 5101:1-40-22, 5101:1-40-25, 5101:1-40-26

Effective: 01/09/2012
R.C. 119.032 review dates: 01/01/2017
Promulgated Under: 111.15
Statutory Authority: 5111.01 , 5111.011
Rule Amplifies: 5111.01 , 5111.011 , 5111.012
Prior Effective Dates: 8/1/1975, 7/1/76, 11/1/1976, 5/14/1977, 12/31/77, 10/26/78, 4/5/1979, 9/21/79, 2/3/80, 10/1/1981, 5/1/82, 12/1/1982, 12/10/82, 12/29/82, 1/13/83, 3/1/1984, 10/1/1984 (Emer.), 12/27/1984, 1/1/85 (Emer.), 4/1/85, 1/2/1986, 4/1/1986, 8/1/86 (Emer.), 10/3/86, 10/1/1987 (Emer.), 12/24/1987, 1/1/88 (Emer.), 3/28/88, 4/1/88 (Emer.), 6/30/88, 10/01/88 (Emer.), 12/20/88, 1/1/89 (Emer.), 3/6/89, 4/1/89, 4/5/89 (Emer.), 5/1/89 (Emer.), 6/18/89, 7/1/1989 (Emer.), 7/8/89, 9/23/89, 10/1/89 (Emer.), 12/16/89, 1/1/1990 (Emer.), 3/2/90, 3/22/90, 4/1/90, 4/2/90 (Emer.), 4/23/90, 6/22/90, 9/1/90 (Emer.), 10/1/90, 4/1/91 (Emer.), 5/1/91, 7/12/1991 (Emer.), 9/12/91, 9/22/1991, 6/30/92, 1/1/93 (Emer.), 3/18/93, 5/1/93, 3/01/94 (Emer.), 4/18/94, 6/20/94, 9/1/1994, 11/1/94, 3/1/95, 10/30/95, 10/31/1997 (Emer.), 1/26/98, 4/4/98, 10/1/99, 11/19/99, 1/1/00, 02/03/00, 7/1/00, 1/1/03, 6/01/02 (Emer.), 8/30/02, 6/1/03 (Emer.), 9/20/03, 1/1/05, 1/1/06, 1/1/08, 3/1/08