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• Native American chooses to opt-out of HIP into MANA

If there is not a second TMA parent, then TMA will end, and children will be explored for eligibility in Hoosier Healthwise.

3815.15.00 COMPLIANCE ELIGIBILITY FACTORS

If any adult in TMA HIP fails to comply with these eligibility requirements, TMA protections will be lost for the entire family even if a second TMA parent is also in the household.

Adults may be subject to a period of excluded eligibility due to a lockout penalty based on the reason why their HIP was closed and would need to file a new application and meet normal HIP eligibility requirements to again receive HIP coverage. Children will always be explored for possible eligibility in a Hoosier Healthwise category.

• The household must comply with any requests for further information or verification of factors which could cause ineligibility. For example, because TMA has no income limit in the first six (6) months, not providing income verification would not cause closure during that time but could after the end of the sixth month. Failure to verify that at least one open and eligible child and/or one eligible adult remains in the household could cause closure at any time. • All minor children in the household must have MEC or be open in Medicaid. If a child does not have MEC (or Medicaid), the parent is no longer eligible for coverage. • POWER Account payments must be paid as invoiced for all TMA adults. If a TMA adult fails to pay the PAC, they will be subject to closure at any time after the sixth month of TMA. If the household is back under 100% FPL, all adults in the household will lose TMA protection but may change to HIP Basic coverage. Unless the adult is Frail, they will lose State Plan benefits if a no-pay happens. • A Frail member who stops paying their PAC and is above 100% FPL will transition to MAPC. The worker will be alerted to re-run eligibility, and if the member is not under ~138% FPL, HIP will be closed • A member who is not frail and stops making payments will be subject to a Lockout period.

Note: Lockouts for non-payment of HIP Power Account Contributions were suspended effective 3/20/22 and removed from the HIP program effective 7/1/21.

3820.00.00 TMA REPORTING/REDETERMINATION

Families receiving Transitional Medical Assistance (TMA) no longer must report their earnings by