Ohio Administrative Code Search

...(A) This rule describes the application of resource rules only when an individual is requesting or receiving medicaid payment for long-term care (LTC) services. (B) Individuals requesting or receiving medicaid payment for LTC services are subject to the following resource rules: (1) The home equity limit as described in rule 5160:1-6-02.1 of the Administrative Code. (2) Evaluation of any qualified long-term care i...

...(A) This rule describes the treatment of the home equity limit for individuals requesting or receiving medicaid payment for long-term care (LTC) services. (B) Definition. "Home equity limit' means the maximum amount of equity which an individual could have in his or her home and become or remain eligible for LTC services. The home equity limit of five hundred sixty thousand dollars will increase annually by the perc...

...(A) This rule describes the treatment of the home equity limit for an individual requesting or receiving medicaid payment for long-term care (LTC) services. (B) Definition. "Home equity limit" means the maximum amount of equity which an individual could have in the home and become or remain eligible for LTC services. The home equity limit of five hundred sixty thousand dollars will increase annua...

...(A) This rule describes the qualified long-term care partnership (QLTCP) program. (B) Definitions. (1) "Estate recovery" means the program set forth in rule 5160:1-2-07 of the Administrative Code. (2) "Qualified long-term care partnership" (QLTCP) means the program established under section 5164.86 of the Revised Code, under which an individual's assets or resources are disregarded in eligi...

...(A) This rule describes the qualified long-term care partnership (QLTCP) program. (B) Definitions. (1) "Estate recovery" means the program set forth in rule 5160:1-2-07 of the Administrative Code. (2) "Qualified long-term care partnership" (QLTCP) means the program established under section 5164.86 of the Revised Code, under which an individual's assets or resources are disregarded in eligi...

...(A) The purpose of this rule is to describe the eligibility requirements for individuals residing in a continuing care retirement community (CCRC), life care community, or a philanthropic long-term care facility (LTCF). (B) Definitions. (1) "Continuing care retirement communities" and "life care communities" mean housing communities that provide different types of care based on each resident's need over time. CCRCs...

...(A) The purpose of this rule is to describe the eligibility requirements for individuals residing in a continuing care retirement community (CCRC), life care community, or a philanthropic long-term care facility (PLTCF). (B) Definitions. (1) "CCRCs" and "life care communities" mean housing communities that provide different categories of care based on each resident's need over time. CCRCs an...

...(A) The following income rules only apply when an individual, regardless of age, is seeking medicaid payment for long-term care services. (1) An individual ineligible for base eligibility due to excess income shall have his or her income eligibility determined using the special income level (SIL), in accordance with rule 5160:1-6-03.1 of the Administrative Code. (2) If an individual's countable income is greater th...

...(A) This rule describes how to determine financial eligibility for medical assistance using the special income level (SIL). This rule does not describe how to determine non-financial eligibility criteria for medical assistance or for medicaid payment of long-term care services. (B) An individual, regardless of age, who is ineligible under base eligibility due to excess income may be income el...

...(A) This rule describes how to determine financial eligibility for medical assistance using the special income level (SIL). This rule does not describe how to determine non-financial eligibility criteria for medical assistance or for medicaid payment of long-term care services. (B) An individual, regardless of age, who is ineligible under base medicaid due to excess income may be income eligible ...

...(A) This rule describes how to determine financial eligibility for medical assistance using the special income level (SIL). This rule does not describe how to determine non-financial eligibility criteria for medical assistance or for medicaid payment of long-term care services. (B) An individual, regardless of age, who is ineligible under base eligibility due to excess income may be income el...

...(A) This rule sets forth the requirements that must be met in order to establish and use a qualified income trust (QIT) (also referred to as a Miller trust) to become eligible for medicaid payment of long-term care services. (B) Definitions (1) "Beneficiary" is defined in rule 5160:1-3-05.2 of the Administrative Code. (2) "Grantor" is defined in rule 5160:1-3-05.2 of the Administrative Code. ...

...(A) This rule describes how to treat the income and resources of the institutionalized spouse (IS) and the community spouse (CS) for purposes of determining eligibility of the IS. When determining eligibility under this rule, the income and resources deeming provisions in Chapter 5160:1-3 of the Administrative Code do not apply. (B) This rule only applies to the financial eligibility determinatio...

...(A) This rule describes how to treat the income and resources of the institutionalized spouse (IS) and the community spouse (CS) for purposes of determining eligibility of the IS. When determining eligibility under this rule, the income and resources deeming provisions in Chapter 5160:1-3 of the Administrative Code do not apply. (B) This rule only applies to the financial eligibility determinatio...

...(A) This rule describes the treatment of income and resources for spouses who are both seeking medicaid payment for LTC services. (B) If both spouses are expected to receive LTC services for less than thirty consecutive days, each spouse's eligibility must be determined in accordance with Chapter 5160:1-3 or 5160:1-4 of the Administrative Code and the rules in Chapter 5160:1-6 of the Administ...

...(A) This rule describes the treatment of income and resources for spouses who are both seeking medicaid payment for LTC services. (B) When both spouses are expected to receive LTC services for less than thirty consecutive days, each spouse's eligibility must be determined in accordance with Chapter 5160:1-3 or 5160:1-4 of the Administrative Code and the rules in Chapter 5160:1-6 of the Admini...

...(A) This rule implements section 1917 of the Social Security Act (as in effect on October 1, 2016) and describes the treatment of transfers of assets when an institutionalized individual, as defined in rule 5160:1-6-01.1 of the Administrative Code, is seeking medicaid payment for long-term care (LTC) services. This rule, and rules 5160:1-6-06.1 to 5160:1-6-06.8 of the Administrative Code, only apply to institutionali...

...(A) This rule describes the treatment of annuity purchases and transactions when an institutionalized individual is requesting medicaid payment for long-term care (LTC) services. (B) The institutionalized individual, or his or her spouse, must disclose any interest that he or she has in an annuity, regardless of whether the annuity is irrevocable or is treated as an asset to the institutionalized...

...(A) This rule describes the treatment of annuity purchases and transactions when an institutionalized individual is requesting medicaid payment for long-term care (LTC) services. (B) The institutionalized individual, or his or her spouse, must disclose any interest that he or she has in an annuity, regardless of whether the annuity is irrevocable or is treated as an asset to the institutionalized...

...(A) This rule describes when transfers, by an institutionalized individual or his or her spouse, involving a trust are considered improper and subject to a restricted medicaid coverage period (RMCP) in accordance with rule 5160:1-6-06.5 of the Administrative Code. (B) This rule does not affect whether the contents of the trust or payments or distributions from a trust are considered resources or income to the instit...

...(A) This rule describes the treatment of transfers involving life estates when an institutionalized individual is requesting medicaid payment for long-term care services. (B) The following steps must be taken to determine whether a transfer involving a life estate, as defined in rule 5160:1-3-05.17 of the Administrative Code, was an improper transfer in accordance with rule 5160:1-6-06 of the Administrative Code: (...

...(A) This rule describes the treatment of transfers involving life estates when an institutionalized individual is requesting medicaid payment for long-term care services. (B) The following steps must be taken to determine whether a transfer involving a life estate, as defined in rule 5160:1-3-05.17 of the Administrative Code, was an improper transfer in accordance with rule 5160:1-6-06 of the Administrative Code: (...

...(A) This rule describes how to treat transfers involving promissory notes, property agreements, and loans held by an institutionalized individuals, or his or her spouse, when the institutionalized individual is requesting medicaid payment for long-term care (LTC) services. (B) Assets used to purchase or obtain a promissory note, property agreement, or loan are considered to be improperly transferred unless the the p...

...(A) This rule describes how to treat transfers involving promissory notes, property agreements, and loans held by an institutionalized individual, or his or her spouse, when the institutionalized individual is requesting medicaid payment for long-term care (LTC) services. (B) Assets used to purchase or obtain a promissory note, property agreement, or loan are considered to be improperly transferred unless the the pu...

...(A) This rule describes how to calculate and apply a restricted medicaid coverage period (RMCP), which is the period of time that long-term care (LTC) services will not be paid for by medicaid because the institutionalized individual improperly transferred an asset. (B) RMCP calculation. (1) Total the value of all improperly transferred assets. (2) When the first month of requested payment ...