Ohio Administrative Code Search
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Rule 5160:1-4-04 | MAGI-based medicaid: coverage for pregnant individuals.
...(A) This rule describes eligibility for pregnant individuals 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 ver... |
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Rule 5160:1-4-05 | MAGI-based medicaid: coverage for a parent or caretaker relative residing with a child.
...(A) This rule describes the eligibility requirements for parents and caretaker relatives residing with children 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 ... |
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Rule 5160:1-4-05 | MAGI-based medicaid: coverage for a parent or caretaker relative residing with a child.
...(A) This rule describes the eligibility requirements for parents and caretaker relatives residing with children 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 ... |
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Rule 5160:1-4-05 | MAGI-based medicaid: coverage for a parent or caretaker relative residing with a child.
...(A) This rule describes the eligibility requirements for parents and caretaker relatives residing with children as described in 42 C.F.R. 435.110 (as in effect October 1, 2024), transitional medical assistance as described in section 1925 of the Social Security Act (as in effect October 1, 2024), and extended medical assistance as described in section 1931 of the Social Security Act (as in effect ... |
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Rule 5160:1-4-06 | Medicaid: coverage for individuals in receipt of adoption or foster care assistance.
...(A) This rule describes eligibility criteria for medical assistance for individuals 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 O... |
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Rule 5160:1-4-06 | Medicaid: coverage for individuals in receipt of adoption or foster care assistance.
...(A) This rule describes eligibility criteria for medical assistance for individuals 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 O... |
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Rule 5160:1-4-06 | Medicaid: coverage for individuals in receipt of adoption or foster care assistance.
...(A) This rule describes eligibility criteria for medical assistance for individuals 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 O... |
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Rule 5160:1-5-01 | Medicaid: the residential state supplement (RSS) program.
...(A) RSS provides cash assistance to aged, blind, or disabled adults who are eligible for medical assistance and who have increased needs due to a medical condition which is not severe enough to require institutionalization. The RSS cash payment is used together with the individual's income to help prevent institutionalization and to deinstitutionalize those aged, blind, or disabled adults who have... |
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Rule 5160:1-5-01 | Medicaid: the residential state supplement (RSS) program.
...(A) RSS provides cash assistance to aged, blind, or disabled adults who are eligible for medical assistance and who have increased needs due to a medical condition which is not severe enough to require institutionalization. The RSS cash payment is used together with the individual's income to help prevent institutionalization and to deinstitutionalize those aged, blind, or disabled adults who have... |
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Rule 5160:1-5-01 | Medicaid: the residential state supplement (RSS) program.
...(A) RSS provides cash assistance to aged, blind, or disabled adults who are eligible for medical assistance and who have increased needs due to a medical condition which is not severe enough to require institutionalization. The RSS cash payment is used together with the individual's income to help prevent institutionalization and to deinstitutionalize those aged, blind, or disabled adults who have... |
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Rule 5160:1-5-02 | Medicaid: breast and cervical cancer project (BCCP).
...(A) This rule describes the medicaid breast and cervical cancer 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 ... |
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Rule 5160:1-5-02 | Medicaid: breast and cervical cancer project (BCCP).
...(A) This rule describes the medicaid breast and 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 ef... |
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Rule 5160:1-5-02.1 | Medicaid: breast and cervical cancer project (BCCP) definitions.
...(A) This rule contains definitions generally used for BCCP. (B) Definitions. (1) "Breast and Cervical Cancer Project (BCCP) medicaid" means the category of medicaid for qualified individuals in need of treatment for breast or cervical cancer, including pre-cancerous conditions and early stage cancer. BCCP medicaid is administered by the Ohio department of medicaid (ODM) in coordination with the ... |
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Rule 5160:1-5-02.1 | Medicaid: breast and cervical cancer project (BCCP) definitions.
...(A) This rule contains definitions generally used for BCCP. (B) Definitions. (1) "Breast and Cervical Cancer Project (BCCP) medicaid" means the category of medicaid for qualified individuals in need of treatment for breast or cervical cancer, including pre-cancerous conditions and early stage cancer. BCCP medicaid is administered by the Ohio department of medicaid (ODM) in coordination with the ... |
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Rule 5160:1-5-02.2 | Medicaid: breast and cervical cancer project (BCCP): eligibility requirements.
...(A) This rule describes the eligibility criteria for BCCP medicaid. (B) An individual shall meet all of the following criteria 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 e... |
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Rule 5160:1-5-02.2 | Medicaid: breast and cervical cancer project (BCCP): eligibility requirements.
...(A) This rule describes the eligibility criteria for BCCP medicaid. (B) An individual shall meet all of the following criteria 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 e... |
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Rule 5160:1-5-02.4 | Medicaid: breast and cervical cancer project (BCCP): application and renewal process.
...(A) This rule describes the application and renewal process for the breast and cervical cancer project (BCCP). (B) The BCCP medicaid application and renewal process shall: (1) Be coordinated between Ohio department of medicaid (ODM), Ohio department of health (ODH) BCCP, and ODH BCCP designated local agencies and/or subgrantees, (2) Be coordinated with ODH BCCP case management services, and... |
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Rule 5160:1-5-02.4 | Medicaid: breast and cervical cancer project (BCCP): application and renewal processes.
...(A) This rule describes the application and renewal process for the breast and cervical cancer project (BCCP). (B) The BCCP medicaid application and renewal process shall: (1) Be coordinated between the Ohio department of medicaid (ODM), Ohio department of health (ODH) BCCP, and ODH BCCP designated local agencies and/or subgrantees, (2) Be coordinated with ODH BCCP case management services,... |
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Rule 5160:1-5-03 | Medicaid: medicaid buy-in for workers with disabilities (MBIWD).
...(A) This rule governs the eligibility requirements for the medical assistance programs authorized under sections 1902(a)(10)(A)(ii)(XV) and (XVI) of the Social Security Act (as in effect October 1, 2019). Medicaid buy-in for workers with disabilities (MBIWD) enables certain individuals to increase their income and resources without the risk of losing medical assistance coverage. (B) Definitions. ... |
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Rule 5160:1-5-03 | Medicaid: medicaid buy-in for workers with disabilities (MBIWD).
...(A) This rule governs the eligibility requirements for the medical assistance programs authorized under sections 1902(a)(10)(A)(ii)(XV) and (XVI) of the Social Security Act (as in effect October 1, 2024). Medicaid buy-in for workers with disabilities (MBIWD) enables certain individuals to increase their income and resources without the risk of losing medical assistance coverage. (B) Definitions. ... |
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Rule 5160:1-5-03 | Medicaid: medicaid buy-in for workers with disabilities (MBIWD).
...(A) This rule governs the eligibility requirements for the medical assistance programs authorized under sections 1902(a)(10)(A)(ii)(XV) and (XVI) of the Social Security Act (as in effect October 1, 2025). Medicaid buy-in for workers with disabilities (MBIWD) enables certain individuals to increase their income and resources without the risk of losing medical assistance coverage. (B) Definitions. (1) "Basic covered ... |
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Rule 5160:1-5-04 | Medicaid: Ohio workability.
...(A) This rule governs the eligibility requirements for the medical assistance program authorized under section 1902(a)(10)(A)(ii)(XIII) of the Social Security Act (as in effect October 1, 2024). Ohio workability enables certain working disabled individuals aged sixty-five or older to increase their income and resources without the risk of losing medical assistance coverage. (B) Definitions. (1) ... |
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Rule 5160:1-5-04 | Medicaid: Ohio workability.
...(A) This rule governs the eligibility requirements for the medical assistance program authorized under section 1902(a)(10)(A)(ii)(XIII) of the Social Security Act (as in effect October 1, 2025). Ohio workability enables certain working disabled individuals aged sixty-five or older to increase their income and resources without the risk of losing medical assistance coverage. (B) Definitions. (1) "Countable income," ... |
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Rule 5160:1-5-04 | Medicaid: Ohio workability.
...(A) This rule governs the eligibility requirements for the medical assistance program authorized under section 1902(a)(10)(A)(ii)(XIII) of the Social Security Act (as in effect October 1, 2024). Ohio workability enables certain working disabled individuals aged sixty-five or older to increase their income and resources without the risk of losing medical assistance coverage. (B) Definitions. (1) ... |
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Rule 5160:1-5-05 | Medicaid: refugee medical assistance (RMA).
...(A) This rule describes a time-limited medical assistance program, funded through the office of refugee resettlement (ORR), that provides a medical screening through contracted refugee health screening providers and other medical services. There is no resource limit for an individual described in this rule. (B) Definitions. (1) "Countable income," for the purpose of this rule, has the same meani... |