Page 6

where there was overlapping Medicare and HIP coverage, when the member’s overlapping Medicare coverage is limited to Part A only.

3515.15.00 MINIMUM ESSENTIAL COVERAGE OF DEPENDENTS

This section is not applicable to low-income parent/caretakers and TMA.

HIP applicants/recipients, who are either a parent or other caretaker relative of a dependent under 19 are required to have their dependents covered under Medicaid, CHIP, or other minimum essential coverage. This is considered verified through attestation by the applicant/recipient parent/caretaker. Such dependents that have applied for or are receiving Medicaid or CHIP meet this requirement.

3515.20.00 OTHER GENERAL HIP ELIGIBILITY REQUIREMENTS

The Medicaid requirements outlined in Chapter 2400 regarding the following are applicable to the HIP program:

• Requirement to provide a Social Security Number • State residency • Assignment of medical rights and medical support cooperation (does not apply to pregnant women and HIP TMA eligible recipients) • Citizenship status, including the documentation requirements.

Emergency-services-only health coverage is available for eligible immigrants who categorically qualify for HIP. Refer to section 2402.20.50.05. Immigrants who categorically qualify for HIP with limited emergency-services-only will be placed under the MARB category, and the effective date of coverage will be the month benefits are authorized by DFR.

Immigrants eligible under MARB with limited emergency-only coverage will not be placed into managed care with a HIP health plan. Immigrants who categorically qualify for HIP with limited emergency-services-only are not required to make any financial contribution to a POWER account. The month of authorization is viewed as the month the payment would have been made had the person been subject to POWER account contributions. DFR must not delay authorization of benefits when an immigrant has met and verified all financial and non-financial requirements to be determined eligible for MARB with limited emergency-services-only. There is no retroactive coverage for any individual receiving emergency services under HIP.

3520.00.00 CATEGORICAL ELIGIBILITY FOR HIP

The following subsections explain the categorical requirements for each HIP category.

3520.05.00 AMERICAN INDIAN/ALASKA NATIVE