Page 26

25

redeterminations are not required. Members who meet eligibility requirements and are receiving benefits in another full coverage category, can continue to receive Medicaid under existing category, but a new applicant or a person who is not currently passing in another category, can go directly to MA 15 (if eligible) without requiring an eligibility determination for any other category. Note: The category of MA 14 for former foster children from states other than Indiana, which included an income test and covered individuals aged 18 – 21, will be phased out as of January 1, 2023, and eligible individuals will instead be covered under MA 15 rules.

2035.30.30 DETERMINATION OF MA E (MED 3)

A person must request that he or she wishes to receive family planning services for an eligibility determination under this category. Services under this category are limited to those related to family planning. Pregnant women who deliver or whose pregnancy is terminated will automatically be considered for MA E if not eligible for another category.

2035.31.00 DESIGNATION OF THE PACKAGE C PREMIUM PAYER

When an Indiana Application for Health Coverage is filed, the person signing the application understands that if the child is eligible for Package C, there will be a premium due before the child can be enrolled. The premium payer is assigned according to the following default logic: mother, father, non-parent caretaker. The caseworker may override the system designation of payer in the following circumstances: • The mother is living in the home and the system has designated her, but it is the father (also in the home) who wants to be the payer. • The child is a ward of the DCS and is placed with someone other than the parents. (If the ward is placed with a parent, the parent will be designated premium payer.) • The child has a legal guardian and is placed with the parent. In this situation, it will be necessary to determine which of these individuals is financially and legally responsible for the child and enter that person as premium payer. 2035.32.00 ENROLLMENT PROCESS FOR MA 10

Once eligibility is established, a conditional approval for MA 10 is to be authorized. This means that the children meet all eligibility requirements of MA 10 except for payment of the first premium(s).