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Rule 5160:1-3-05.13 | Medicaid: treatment of the home.

...cal 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 inter...

Rule 5160:1-3-05.14 | Medicaid: resource exclusions.

...r disabled. (B) Resource exclusions. (1) Resources excluded by federal laws other than the Social Security Act, in accordance with 20 C.F.R. 416.1236 (as in effect October 1, 2020), unless otherwise noted. This list contains unspent income from exempt sources: (a) Agent orange settlement payments received on or after January 1, 1989, under the Agent Orange Compensation Exclusion Act (Pub. L. No. ...

Rule 5160:1-3-05.16 | Medicaid: home replacement exclusion.

...sulting 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...

Rule 5160:1-3-05.17 | Medicaid: life estates.

...medical assistance. (B) Definitions. (1) "Date of signature" is the date on which an individual with authority to transfer the property actually signed. (2) "Life estate" means an ownership interest in property wherein one person holds the right to possess, use, and obtain profits from the property as long as he or she lives, while another person holds the actual ownership interest in the property. (a) A life est...

Rule 5160:1-3-05.17 | Medicaid: life estates.

...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 po...

Rule 5160:1-3-05.18 | Medicaid: stocks, mutual funds, and bonds.

...ghts, 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 d...

Rule 5160:1-3-05.18 | Medicaid: stocks, mutual funds, and bonds.

...d 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 fair 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 finan...

Rule 5160:1-3-05.20 | Medicaid: deeming of resources.

...medical assistance. (B) Definitions. (1) "Child," for deeming purposes, means an individual under age eighteen who lives in the household with one or both parents and is neither married nor head of household. The deeming of parental resources applies through the month in which the eligible child becomes eighteen years old. An eligible or ineligible child's resources are never deemed to parent(s)...

Rule 5160:1-4-01 | MAGI-based medicaid: household composition and income.

....F.R. 435.603 (as in effect October 1, 2020) when determining an individual's eligibility for modified adjusted gross income (MAGI) based medical assistance. This rule does not apply to determinations for categories of medical assistance on the basis of age, blindness, or disability, or which only cover an individual's medicare premium or cost-sharing. (B) Definition. "Person" for the purpose...

Rule 5160:1-4-02 | MAGI-based medicaid: coverage for children younger than nineteen years of age.

... 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 automat...

Rule 5160:1-4-03 | MAGI-based medicaid: coverage for Ribicoff and former foster care children.

...r 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...

Rule 5160:1-4-03 | MAGI-based medicaid: coverage for Ribicoff and former foster care children.

...r 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...

Rule 5160:1-4-04 | MAGI-based medicaid: coverage for pregnant individuals.

...dividuals as described in 42 C.F.R. 435.116 (as in effect on October 1, 2016) 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 plan is sufficient verification of pregnancy, unless the administrative agency has information contradicting th...

Rule 5160:1-4-04 | MAGI-based medicaid: coverage for pregnant individuals.

...dividuals 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 agenc...

Rule 5160:1-4-05 | MAGI-based medicaid: coverage for a parent or caretaker relative residing with a child.

...ldren as described in 42 C.F.R. 435.110 (as in effect October 1, 2019), transitional medical assistance as described in section 1925 of the Social Security Act (as in effect October 1, 2019), and extended medical assistance as described in section 1931 of the Social Security Act (as in effect October 1, 2019). (B) Eligibility criteria for coverage because an individual is a parent or caretake...

Rule 5160:1-4-05 | MAGI-based medicaid: coverage for a parent or caretaker relative residing with a child.

...ldren 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 caretake...

Rule 5160:1-4-06 | Medicaid: coverage for individuals in receipt of adoption or foster care assistance.

...ndividuals 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, 2022); 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, 2022). (B) Individual or authorized representative respons...

Rule 5160:1-4-06 | Medicaid: coverage for individuals in receipt of adoption or foster care assistance.

...ndividuals 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, 2019); 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, 2019). (B) Individual or authorized representative respons...

Rule 5160:1-4-06 | Medicaid: coverage for individuals in receipt of adoption or foster care assistance.

...ndividuals 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). (B) Individual or authorized representative respons...

Rule 5160:1-5-01 | Medicaid: the residential state supplement (RSS) program.

...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 ...

Rule 5160:1-5-01 | Medicaid: the residential state supplement (RSS) program.

...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 ...

Rule 5160:1-5-01 | Medicaid: the residential state supplement (RSS) program.

...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 ...

Rule 5160:1-5-02 | Medicaid: breast and cervical cancer project (BCCP).

...cer 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 medi...

Rule 5160:1-5-02 | Medicaid: breast and cervical cancer project (BCCP).

...nd cervical cancer project. (B) Rules 5160:1-5-02 to 5160:1-5-02.4 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 October 1, 2024), authorizes an optional...

Rule 5160:1-5-02.2 | Medicaid: breast and cervical cancer project (BCCP): eligibility requirements.

...ria 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...