Ohio Administrative Code Search

...(A) This rule sets forth acceptable documentary evidence of United States (U.S.) citizenship and the circumstances under which an individual who declares U.S. citizenship, under penalty of perjury, may be given a reasonable opportunity to verify U.S. citizenship. (B) Any individual applying for medical assistance and declaring U.S. citizenship or nationality shall verify citizenship in accord...

...(A) This rule sets forth acceptable documentary evidence of United States (U.S.) citizenship and the circumstances under which an individual who declares U.S. citizenship, under penalty of perjury, may be given a reasonable opportunity to verify U.S. citizenship. (B) Any individual applying for medical assistance and declaring U.S. citizenship or nationality shall verify citizenship in accord...

...(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 describes the conditions under which an individual may receive time-limited medical assistance as a result of an initial, simplified determination of eligibility based on the individual's self-declared statements. (B) Eligibility criteria for presumptive coverage. (1) Except as set forth in paragraph (B)(2) of this rule, an individual is eligible for presumptive coverage if the...

...(A) This rule describes the conditions under which an individual may receive time-limited medical assistance as a result of an initial, simplified determination of eligibility based on the individual's self-declared statements. (B) Eligibility criteria for presumptive coverage. (1) Except as set forth in paragraph (B)(2) of this rule, an individual is eligible for presumptive coverage when t...

...(A) This rule describes the twelve-month period of continuous eligibility for a child younger than age nineteen, and the conditions under which the child's coverage ends during the twelve-month 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 circums...

...(A) This rule describes the twelve-month period of continuous eligibility for a child younger than age nineteen, and the conditions under which the child's coverage ends during the twelve-month 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 circums...

...(A) The purpose of this rule is to explain the requirements of healthchek, Ohio's early and periodic screening, diagnostic and treatment (EPSDT) benefit that all medicaid eligible individuals under twenty-one years of age are entitled to receive. A separate healthchek application is not required. Each county department of job and family services (CDJFS) is required to have a healthchek coordin...

...(A) This rule explains the requirements of healthchek, Ohio's early and periodic screening, diagnostic and treatment (EPSDT) benefit that is mandatory for an individual under twenty-one years 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 Socia...

...(A) The purpose of this rule is to outline the responsibilities of the administrative agency to inform medicaid-eligible pregnant women about the benefits and importance of pregnancy related services (PRS), to make requested or needed referrals to support services, and to provide non-medical services promoting healthy birth outcomes in accordance with 42 C.F.R. 440.210 (as in effect January 1, 2014). (B) Definitions...

...(A) The purpose of this rule is to outline the responsibilities of the administrative agency to inform a pregnant woman eligible for medical assistance about the benefits and importance of pregnancy related services (PRS), to make requested or needed referrals to support services, and to provide non-medical support services that promote healthy birth outcomes in accordance with 42 C.F.R. 440.210 (...

...(A) The medicaid program provides coverage for individuals who meet the aged, blind, or disability 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 co...

...(A) The medicaid program provides coverage for individuals who meet the aged, blind, or disability status 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 catego...

...(A) The medicaid program provides coverage for individuals who have been determined to meet the criteria for the limiting physical factors of age, blindness, 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 administrat...

...(A) The medicaid program provides coverage for individuals who have been determined to meet the criteria for the limiting physical factors of age, blindness, or 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...

...(A) This rule sets forth the eligibility criteria and benefits for the medicare premium assistance programs (MPAP). The programs are: qualified medicare beneficiary (QMB), specified low-income medicare beneficiary (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 al...

...(A) This rule sets forth the eligibility criteria and benefits for the medicare premium assistance programs (MPAP). The programs are: qualified medicare beneficiary (QMB), specified low-income medicare beneficiary (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 ...

...(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...

...(A) This rule describes eligibility for medical assistance for aged, blind or disabled individuals who receive SSI benefits authorized by the social security administration under Title XVI of the Social 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...

...(A) This rule describes eligibility for medical assistance for aged, blind, or disabled individuals who receive SSI benefits authorized by the social security administration under Title XVI of the Social Security Act (as in effect October 1, 2023). (B) Eligibility criteria. To be eligible for coverage under this group an individual must be receiving SSI benefits based on the social security admin...

...(A) This rule describes eligibility for aged, blind or disabled individuals who meet the income and resource requirements of the supplemental security income (SSI) program authorized by the social security administration (SSA) under Title XVI of the Social Security Act (as in effect on February 1, 2016) but do not receive cash benefits under the program. Eligibility for this program shall be deter...

...(A) This rule describes eligibility for aged, blind, or disabled individuals who meet the income and resource requirements of the supplemental security income (SSI) program authorized by the social security administration (SSA) under Title XVI of the Social Security Act (as in effect October 1, 2022) but who do not receive cash benefits under the program. Eligibility for this program shall be dete...

...(A) This rule describes the eligibility criteria for continued medical assistance coverage for an individual who is receving SSI benefits under section 1619 of the Social Security Act. (B) Section 1619 of the Social Security Act (as in effect October 1, 2022) comprises two basic provisions: (1) Section 1619(a) extends special SSI cash to individuals whose earnings preclude eligibility for re...

...(A) Various grandfathering provisions and deemed eligibility requirements were enacted to assure that aged, blind, or disabled individuals previously eligible for cash assistance and medicaid under former programs of aid would not be disadvantaged by eligibility conditions when the supplemental security income (SSI) program was implemented. (B) Definitions. (1) "Cash assistance," for the pu...