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Indiana Health Coverage Program Policy Manual Chapter 1600 CATEGORIES OF ASSISTANCE Sections 1600.00.00 – 1621.00.00

Contents 1600.00.00 CATEGORIES OF ASSISTANCE ...................................................................... 2

1600.05.00 MEDICAID ELIGIBILITY CATEGORIES SUMMARY ..................................... 2 1610.00.00 MEDICAL ASSISTANCE FOR THE AGED, BLIND & DISABLED (MED 1, MED 4) . 2

1610.02.00 SSI ELIGIBLE INDIVIDUALS (MED 1) ........................................................ 3

1610.05.00 AGED INDIVIDUALS (MED 1) .................................................................. 4 1610.10.00 BLIND INDIVIDUALS (MED 1) ................................................................. 4 1610.20.00 DISABLED INDIVIDUALS (MED 1) ........................................................... 4 1610.25.00 RCAP ELIGIBLE INDIVIDUALS (MED 1) .................................................... 5 1610.26.00 EMPLOYEES WITH DISABILITIES (MED 1) ............................................... 5

1610.30.00 QUALIFIED MEDICARE BENEFICIARY (MED 4) ........................................ 5 1610.35.00 SPECIFIED LOW-INCOME MEDICARE BENEFICIARY (MED 4) ................... 6 1610.40.00 QUALIFIED DISABLED WORKER (MED 4) ................................................ 6 1610.45.00 QUALIFIED INDIVIDUALS (MED 4) .......................................................... 6 1610.45.10 MEDICARE BUY-IN PROGRAM BENEFITS ...................................................... 6 1610.46.00 APPLYING THE SIL (SPECIAL INCOME LEVEL) BUDGET FOR MEMBERS RESIDING IN FACILITIES ...................................................................... 9 1610.47.00 APPLYING THE SIL (SPECIAL INCOME LEVEL) BUDGET FOR HCBS WAIVERS.... 9 1610.50.00 PREGNANT HOOSIER WHOSE INCOME INCREASES .............................. 10 1620.00.00 HOOSIER HEALTHWISE (MED 3) ................................................................ 10

1620.05.00 LOW INCOME PARENTS / CARETAKERS ............................................... 11 1620.05.15 TRANSITIONAL MEDICAL ASSISTANCE ................................................. 12

1620.35.00 RESERVED ........................................................................................... 12 1620.35.05 NATIVE AMRICAN/ALASKA NATIVE HIP (MED 3) .................................. 12 1620.36.00 HIP STATE PLAN PLUS (MED 3) ............................................................ 12 1620.37.00 HIP BASIC-STATE PLAN (MED 3) .......................................................... 13 1620.38.00 HIP STATE PLAN PLUS WITH CO-PAYS (MED 3) .................................... 13 1620.39.00 HIP REGULAR PLAN PLUS (MED 3) ....................................................... 13 1620.39.05 HIP REGULAR BASIC (MED 3) ............................................................... 14 1620.40.00 CHILDREN IN PSYCHIATRIC FACILITIES (MED 3) .................................... 14 1620.45.00 REFUGEE MEDICAL ASSISTANCE (MED 2) ............................................ 14 1620.50.00 PREGNANT HOOSIERS - FULL COVERAGE (MED 3) ............................... 15

1620.60.00 CHILDREN UNDER AGE 1 (MED 3) ....................................................... 16