Page 25

24

This category, established effective January 1, 2000, includes children aging from birth through the age of 18, who are not eligible in any other medical category. MA 10 is Benefit Package C of Hoosier Healthwise. The income standards were set at 200% of the federal poverty guidelines until October 1, 2008, when they were increased under an MA 10 expansion to 250% of the federal poverty guidelines. The standards are listed in Sections 3010.30.20 and 3010.30.25. Information on budgeting under the expansion is found at Section 3460.15.05.

MA 10 is positioned at the bottom of the medical hierarchy due to the requirement that eligibility be pursued under the other categories first. However, the same provision as in MA 9, that is applied to children who would be eligible in the Blind and Disabled categories is applicable to MA 10. Refer to the previous section, 2035.30.05.

2035.30.15 DETERMINATION OF MEDWorks CATEGORY

A disabled individual will be considered under all applicable categories according to the hierarchy. If the individual’s gross earnings, minus Impairment-Related Work Expenses (IRWE) exceed the Substantial Gainful Activity amount specified in Section 3046.00.00, or their total countable income or resources exceed the MA D limits listed in Chapter 3000, they will then be considered for eligibility in MEDWorks. MADW is considered first.

An applicant for Medicaid cannot be approved initially in MADI.

If the Medical Review Team or the Social Security Administration determines that an MADW recipient is no longer disabled due to a medical improvement in his condition, MRT will determine whether the improvement does not constitute a full medical recovery. If there is not a full medical recovery, such individual will be determined for MADI categorical eligibility. 2035.30.20 DETERMINATION OF MA 14 CATEGORY (MED 3)

Note: Effective 1/1/23, Former foster care children enrolled in Medicaid (any state) on their 18th birthday will transition to MA 15 (Refer to 1620.74.00 and 2035.30.25). 2035.30.25 DETERMINATION OF MA 15 CATEGORY (MED 3)

This category includes individuals who were in Foster Care and enrolled in Medicaid (any state) upon attaining age 18 and who are less than 26 years of age. This category is open to former foster care individuals who are Indiana residents and are not enrolled in another category of Medicaid. There is no income or asset test, and annual