Ohio Administrative Code Search

... assistance, an individual shall: (1) Provide a social security number (SSN) in accordance with 42 C.F.R. 435.910 (as in effect October 1, 2024). (a) The individual's self-declaration of SSN meets this condition unless contradictory information is provided to or maintained by the administrative agency. (b) An individual is not required to provide an SSN when the individual: (i) Is applying...

...42 C.F.R. 435.407 (as in effect October 1, 2019). (1) After an individual's U.S. citizenship or nationality is verified by the administrative agency, the administrative agency shall not require the individual to re-verify citizenship. (2) The following individuals are not required to verify their U.S. citizenship: (a) An individual applying for medical assistance only for other individuals....

...42 C.F.R. 435.407 (as in effect October 1, 2022). (1) After an individual's U.S. citizenship or nationality is verified by the administrative agency, the administrative agency shall not require the individual to re-verify citizenship. (2) The following individuals are not required to verify their U.S. citizenship: (a) An individual applying for medical assistance only for other individuals....

...iance to the U.S. as defined in 8 U.S.C 1101(a)(22) (as in effect October 1, 2025) and is treated the same as a U.S. citizen for medicaid eligibility purposes in accordance with 42 C.F.R 435.406 (as in effect October 1, 2025). (C) Any individual applying for medical assistance and declaring to be a U.S. citizen or a national of the U.S.shall verify citizenship in accordance with 42 C.F.R. 435.407 (as in effect Octob...

...(A) This rule sets forth: (1) Medical assistance eligibility criteria for an individual who is not a U.S. citizen or national; and (2) Acceptable documentary evidence of qualified non-citizen status; and (3) The circumstances under which an individual who declares qualified non-citizen status, under penalty of perjury, may be given a reasonable opportunity to verify that status. (B) Defin...

...(A) This rule sets forth: (1) Medical assistance eligibility criteria for an individual who is not a United States (U.S.) citizen or a national of the U.S.; (2) Acceptable documentary evidence of qualified non-citizen status; and (3) The circumstances under which an individual who declares qualified non-citizen status, under penalty of perjury, may be given a reasonable opportunity to verify that status. (B) Def...

...ount of income and resources to deem. (1) In accordance with 8 U.S.C. 1182 (as in effect October 1, 2024), certain non-citizens seeking lawful permanent resident (LPR) status are required to provide an affidavit of support from a sponsor(s). A sponsor must agree to assume financial support for the non-citizen. (2) When determining the non-citizen's eligibility for medical assistance, the income and resources of the...

...riteria for presumptive coverage. (1) Except as set forth in paragraph (B)(2) of this rule, an individual is eligible for presumptive coverage if the individual: (a) Is a resident of the state of Ohio; and (b) Is a U.S. citizen or has an immigration status as defined in rule 5160:1-2-12 of the Administrative Code that allows for medicaid eligibility; and (c) Meets the non-financial eligibility...

...riteria for presumptive coverage. (1) Except as set forth in paragraph (B)(2) of this rule, an individual is eligible for presumptive coverage when the individual: (a) Is a resident of the state of Ohio; and (b) Is a U.S. citizen or has an immigration status as defined in rule 5160:1-2-12 of the Administrative Code that allows for medicaid eligibility; and (c) Meets the non-financial eligibili...

...nth period, as described in section 1902(e)(12) of the Social Security Act (as in effect October 1, 2019). (B) Eligibility criteria. A child remains eligible for coverage despite changes in the child's circumstances for a period of twelve months if the child was found to be eligible for a category of medical assistance other than: (1) Presumptive eligibility as described in Chapter 5160:1-1 ...

...nth period, as described in section 1902(e)(12) of the Social Security Act (as in effect October 1, 2023). (B) Eligibility criteria. A child remains eligible for coverage despite changes in the child's circumstances for a period of twelve months when the child was found to be eligible for a category of medical assistance other than: (1) Presumptive eligibility as described in rule 5160:1-2-1...

...ng terms have the following meanings: (1) "Healthchek" is Ohio's early and periodic screening, diagnostic and treatment benefit for all medicaid eligible individuals under twenty-one years of age. (2) "Healthchek coordinator" is the CDJFS employee who is responsible for the implementation of healthchek services. (3) "Healthchek services" are periodic screening services (including a comprehensiv...

... of age who is enrolled in medicaid. (1) The healthchek benefit provides comprehensive preventative, diagnostic, and treatment services for an eligible individual as specified in Section 1905(r) of the Social Security Act (as in effect October 1, 2024). (2) There is no separate enrollment for healthchek. When an individual is eligible for medical assistance and is under twenty-one years of age,...

...comes in accordance with 42 C.F.R. 440.210 (as in effect January 1, 2014). (B) Definitions. (1) "Individual" for the purpose of this rule, means a medicaid-eligible individual who is pregnant, as verified by either self-declaration or medical verification, including the sixty days post-partum period. (2) ODM 03515 "Pregnancy Related Services Implementation Plan" (PRSIP) (rev. 1/2015) means the document submitted b...

...comes in accordance with 42 C.F.R. 440.210 (as in effect October 1, 2023). (B) Definitions. (1) "Administrative agency," for the purpose of this rule, means the county department of job and family services (CDJFS). (2) "Individual" for the purpose of this rule, means a pregnant woman eligible for medical assistance, as verified by either self-declaration or medical verification, including d...

...sability status as set forth in section 1902 of the Social Security Act (as in effect on February 1, 2016). The provisions of Chapter 5160:1-3 of the Administrative Code establish eligibility criteria, standards, and procedures that apply to individuals enrolling in an aged, blind or disability categorical coverage group. (B) The rules of this chapter are organized as follows: (1) Rules under pr...

... requirements as set forth in section 1902 of the Social Security Act (as in effect October 1, 2022). The provisions of Chapter 5160:1-3 of the Administrative Code establish eligibility criteria, standards, and procedures that apply to individuals enrolling in an aged, blind, or disabled categorical coverage group. (B) The rules of this chapter are organized as follows: (1) Rules under princip...

..., or disability as set forth in section 1902 of the Social Security Act (as in effect on October 1, 2016). Age is determined by county departments of job and family services (CDJFS). Blindness and disability are determined by either the social security administration (SSA) or the Ohio department of medicaid (ODM) in accordance with rule 5160:1-3-02.9 of the Administrative Code. The criteria are as follows: (1) Age: ...

... disability as set forth in section 1902 of the Social Security Act (as in effect on October 1, 2024). Age is determined by county departments of job and family services (CDJFSs). Blindness and disability are determined by either the social security administration (SSA) or the Ohio department of medicaid (ODM) in accordance with rule 5160:1-3-02.9 of the Administrative Code. (B) The criteria for ...

...ciary (SLMB), qualified individuals (QI-1), and qualified disabled and working individuals (QDWI). (B) Definitions. (1) "Eligible," for the purpose of this rule, means an individual meets all the requirements to enroll in MPAP. (2) "Enrolled," for the purpose of this rule, means an individual is in receipt of benefits under a medicare health plan. (3) "Entitled" for the purpose of this rul...

...iciary (SLMB), qualified individual (QI-1), and qualified disabled and working individual (QDWI). (B) Definitions. (1) "Eligible," for the purpose of this rule, means an individual meets all the requirements to enroll in MPAP. (2) "Enrolled," for the purpose of this rule, means an individual is in receipt of benefits under a medicare health plan. (3) "Entitled," for the purpose of this rul...

...iciary (SLMB), qualified individual (QI-1), and qualified disabled and working individual (QDWI). (B) Definitions. (1) "Eligible," for the purpose of this rule, means an individual meets all the requirements to enroll in MPAP. (2) "Enrolled," for the purpose of this rule, means an individual is eligible for, and in receipt of benefits under a medicare health plan through the social security administration (SSA). ...

...(A) This rule sets forth: (1) The eligibility criteria for benefits under the medicare part B buy-in agreement between the social security administration (SSA) and the Ohio department of medicaid (ODM), which allows ODM to pay medicare part B (supplemental medical insurance) premiums for certain medicaid-eligible individuals even if those individuals are not eligible for a medicare premium assist...

...(A) This rule sets forth: (1) The eligibility criteria for benefits under the medicare part B (part B) buy-in agreement between the social security administration (SSA) and the Ohio department of medicaid (ODM), which allows ODM to pay part B (supplemental medical insurance) premiums for certain individuals even when those individuals are not eligible for a medicare premium assistance program (MP...

...l Security Act (as in effect on October 1, 2017). Eligibility for this category shall be determined for applications for medical assistance filed on or after August 1, 2016. (B) Eligibility criteria. To be eligible for coverage under this group an individual must be receiving SSI benefits based on the social security administration's determination of eligibility for SSI payments. In addition, cer...