Ohio Administrative Code|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 October 1,
			 2019).
(B) Individual or authorized
		  representative responsibilities. The individual or authorized representative
		  must:
(1) Sign and date the
			 application; and
(2) Meet the conditions
			 of eligibility described in rule 5160:1-2-10 of the Administrative Code;
			 and
(3) Cooperate in
			 establishing eligibility; and
(4) Report changes that
			 impact the eligibility criteria identified in this rule in accordance with rule
			 5160:1-2-08 of the Administrative Code.
(C) Eligibility criteria for an
		  individual in receipt of adoption or foster care assistance under Title IV-E of
		  the Social Security Act (as in effect October 1, 2019).
(1) The individual
			 must:
(a) Meet the age requirements identified in Chapter 5101:2-47 of
				the Administrative Code and be in the custody of a public children services
				agency (PCSA), private child placing agency (PCPA), or Title IV-E agency and in
				receipt of Title IV-E foster care maintenance payments; or
(b) Meet the age requirements identified in Chapter 5101:2-49 of
				the Administrative Code and have a Title IV-E adoption agreement in effect,
				whether or not an adoption assistance payment is being made or a judicial
				decree of adoption has been issued.
(2) If the individual
			 receives adoption or foster care assistance under Title IV-E of the Social
			 Security Act and meets the eligibility criteria under this paragraph, there is
			 no income or resource test required to be eligible for medical
			 assistance.
(D) Eligibility criteria for an
		  individual in receipt of state foster care assistance.
(1) The individual
			 must:
(a) Be in the custody of a PCSA, PCPA, or Title IV-E agency;
				and
(b) Be in receipt of state foster care assistance.
(2) If the individual
			 receives state foster care assistance and meets the eligibility criteria under
			 this paragraph, there is no income or resource test required to be eligible for
			 medical assistance.
(E) Eligibility criteria for an
		  individual in receipt of a state adoption assistance subsidy.
(1) The individual
			 must:
(a) Meet the age requirements identified in rule 5101:2-44-06 of
				the Administrative Code; and
(b) Have a state adoption agreement in effect, whether or not a
				judicial decree of adoption has been issued.
(2) If the individual
			 receives a state adoption assistance subsidy and meets the eligibility criteria
			 under this paragraph, there is no income or resource test required to be
			 eligible for medical assistance.
(F) Eligibility criteria for an
		  individual in receipt of state adoption assistance in accordance with 42 C.F.R.
		  435.227 (as in effect October 1, 2019).
(1) The individual
			 must:
(a) Be under the age of twenty-one; and
(b) Have been determined by the PCSA responsible for determining
				state adoption maintenance subsidy program eligibility to have special needs
				for medical or rehabilitative care that may be a barrier to the adoptive
				placement, as described in rule 5101:2-44-05.1 of the Administrative Code, or
				have a state adoption subsidy agreement in effect with another state, as
				described in rule 5101:2-44-05.2 of the Administrative Code; and
(c) Have been receiving or eligible to receive medicaid prior to
				the execution of the adoption agreement, under any category of medical
				assistance.
(2) If the individual
			 receives state adoption assistance, has special needs for medical or
			 rehabilitative care, and meets the eligibility criteria under this paragraph,
			 there is no income or resource test required to be eligible for medical
			 assistance.