MaineCare Eligibility Manual

Full version of the Mainecare Eligibility Manual - Last Revision August 2012 Microsoft Word* | Adobe PDF*

Table of Contents

Chapter 332

  • Part 1 General Information [show/Hide] (Microsoft Word* or Adobe PDF*)
    • Section 1 Introduction
    • Section 2 Confidentiality
      • 2.1 Release of Information
      • 2.2 Written Release of Information
      • 2.3 Information from an External Source
    • Section 3 Referrals
      • 3.1 Referrals to Child and Adult Protective Services
      • 3.2 Referral to FIR Unit from the Eligibility Unit
      • 3.3 Referrals to FIR Unit from an Outside Source;
    • Section 4 Replacement of Medical Identification Cards
    • Section 5 Out of State Coverage
    • Section 6 Outreach
    • Section 7 Administrative Hearings
      • 7.1 Requesting a Hearing
      • 7.2 Continuation of Benefits
      • 7.3 Conducting a Hearing
        • 7.3.1 The Hearing Officer’s Review of the Department’s Decision
        • 7.3.2 The Individual or the Individual's Representative
        • 7.3.3 Following the Hearing, a written decision will be prepared
      • 7.4 Implementing Results
      • 7.5 Judicial Review
    • Section 8 Record Retention
  • Part 2 Basic Eligibility Criteria [Show/Hide] (Microsoft Word* or Adobe PDF*) -- Last Revision December 2011
    • Section 1 Scope of the Program
    • Section 2 Coverage Groups and Assistance Units
    • Section 3 Citizenship
      • 3.1Citizenship and Identity Requirements
      • 3.2 Emergency Benefits
      • 3.3Documentation and Verification for Non-Citizens
    • Section 4 Residency
      • 4.1 Children
      • 4.2 Title IV-E
      • 4.3 Residents of Medical Institutions
      • 4.4 SSI and State Supplement Recipients
    • Section 5 Social Security Numbers
      • 5.1 Non-Compliance/Sanctions/Good Cause
      • 5.2 Retroactive Coverage
    • Section 6 Assignment of Rights to Medical Payments
      • 6.1 Who must comply
      • 6.2 What is required
      • 6.3 Non-compliance
    • Section 7 Cooperation in Obtaining Medical Support
      • 7.1 Who Must Comply
      • 7.2 What is Required
      • 7.3 Non-Compliance
    • Section 8 Good Cause
    • Section 9 Individuals Residing in Public Institutions
    • Section 10 Application for Other Benefits
    • Section 11 Application Process
      • 11.1 Subsequent requests for eligibility
      • 11.2 Recipients of SSI or State Supplement
    • Section 12 Client and Agency Responsibilities
      • 12.1 Verification of Eligibility Factors
      • 12.2 Reporting Responsibilities
      • 12.3 Temporary Coverage
        • 12.3.1 Forty Five (45) Day Processing Standard
        • 12.3.2 Ten (10) day processing standard for deductibles
        • 12.3.3 Ending of Temporary Coverage
    • Section 13 Eligibility Periods/Reviews
      • 13.1 Changes within the Eligibility Period
      • 13.2 Medically Needy Eligibility Periods
      • 13.3 Changes within the Medically Needy Eligibility Period
      • 13.4 Retroactive Period
    • Section 14 Closings and Denials
    • Section 15 Notices
    • Section 16 Unfunded Checks
  • Part 3 Categorically Needy Families with Children Related Coverage [Show/Hide] (Microsoft Word* or Adobe PDF*) --Last Revision January 2011
    • Section 1 Covered Individuals
    • Section 2 Covered Groups Overview
    • Section 3 Financial Responsibility of Relatives
    • Section 4 Coverage Groups Detail
      • 4.1 Section 1931
        • 4.1.1 Maintenance of a Home
        • 4.1.2 Physical Separation
      • 4.2 Transitional Medicaid
        • 4.2.1 Families with Earnings
        • 4.2.2 Initial Six Month Extension (Months One - Six)
        • 4.2.3 Second Six Month Extension (Months Seven - Twelve)
        • 4.2.4 Families who Become Ineligible Due to Increased Child Support
      • 4.3 Pregnant Women
        • 4.3.1 Presumptive Eligibility for Pregnant women
      • 4.4 Individuals under Age 21 (Through age 20)
      • 4.5 Other Special Groups
        • 4.5.1 Refugees/Asylees
        • 4.5.2 IV-E Eligibles and State Adoption Assistance
        • 4.5.3 Parents and Caretaker Relatives with income between 150% - 200% FPL
  • Part 4 Family - Related Budgeting [ Show/Hide] (Microsoft Word* or Adobe PDF*) -- Last Revision June 2012
    • Section 1 Family - Related Asset Limit
    • Section 2 Family - Related Income Limits
    • Section 3 Basic Budgeting Principles
      • 3.1 Assistance Unit Size
      • 3.2 Use of Income
      • 3.3 Determination of Gross Monthly Income
      • 3.4 Disregards
        • 3.4.1 Disregards from all Income
        • 3.4.2 Earned Income Disregards
      • 3.5 Income Limit
      • 3.6 Special Budgeting Procedures
        • 3.6.1 Stepparents
        • 3.6.2 Pregnant Minors and Minor Parents
        • 3.6.3 Strikers
        • 3.6.4 Family Members who are SSI/State Supplement Recipients
  • Part 5 Children’s Health Insurance Program (CHIP) Cub Care [ Show/Hide] (Microsoft Word* or Adobe PDF*) --Last Revision   September 2010
    • Section 1 Scope
    • Section 2 Basic Eligibility Requirements
    • Section 3 Application Process
    • Seciton 4 Assets
    • Section 5 Income
    • Section 6 Budgeting
    • Section 7 Changes
    • Section 8 Eligibility Periods
    • Section 9 Notices
    • Section 10 Administrative Hearings
    • Section 11 Premiums
      • 11.1 General
      • 11.2 Coverage for the Current Enrollment Period
      • 11.3 Nonpayment of Premiums
      • 11.5 Refunds
  • Part 6 Supplemental Security Income (SSI) – Related Medicaid Coverage [Show/Hide] (Microsoft Word* or Adobe PDF*)
    • Section 1 SSI and Medicaid
    • Section 2 SSI Appeals of Disability Decisions
    • Section 3 Retroactive Medicaid Benefits for SSI Recipients
    • Section 4 Basic Eligibility Requirements
      • 4.1 Aged
      • 4.2 Blind
      • 4.3 Disabled
        • 4.3.1 Making the Decision
        • 4.3.2 Referral to Vocational Rehabilitation
        • 4.3.3 Reconsiderations (Appeals)
        • 4.3.4 Determination of Continued Eligibility when the Disabled Individual Begins to Work
    • Section 5 Covered Individuals
      • 5.1 Definitions
      • 5.2 Eligible Groups
        • 5.2.1 Individuals or Couples Meeting SSI/State Supplement Criteria
        • 5.2.2 Individuals or Couples Eligible Under the Pickle Amendment or Lynch VS. Rank
        • 5.2.3 Individuals or Couples Residing in Adult Foster Homes (Private or State Assisted) or Flat Rate Boarding Homes
        • 5.2.4 Individuals or Couples Residing in Cost Reimbursement Boarding Homes, and Residential Care Facilities
        • 5.2.5 Individuals in Nursing Care Facilities
        • 5.2.6 Individuals Receiving Nursing Care in Community Settings
        • 5.2.7 Newborns Born to Mothers on Medicaid
        • 5.2.8 Children Eligible Under “Katie Beckett”
        • 5.2.9 Certain Individuals Receiving Social Security Disabled Widow(er)’s Benefits who are not Receiving Medicare
        • 5.2.10 Disabled Adult Children (DAC)
        • 5.2.11 Other Covered Group
        • 5.2.12 Individuals Under Age 18 Who are Closed From SSI Due to 8/96 Change in Disability Criteria
        • 5.2.13 Working Disabled
        • 5.2.14 Section 1619(b)
  • Part 7 SSI - Related Medicaid Budgeting [ Show/Hide] (Microsoft Word* or Adobe PDF*) --Last Revision January 2011
    • Section 1 Treatment of SSI - Related Assets
      • 1.1 Categorically Needy Asset Limit
      • 1.2 Working Disabled Asset Limits
      • 1.3 Deeming of Assets
        • 1.3.1 Exclusions to Deeming Process
        • 1.3.2 Duration of Deeming
    • Section 2 SSI - Related Income Budgeting Process
      • 2.1   Disregards
        • 2.1.1 Federal Disregard
        • 2.1.2 Impairment-Related Work Expenses (IRWE)
        • 2.1.3 Earned Income Disregard
        • 2.1.4 State Disregard
        • 2.1.5 Special Group Disregards
      • 2.2 Deeming of Income
        • 2.2.1 Allocation
        • 2.2.2 Exclusions to Deeming Process
        • 2.2.3 Duration of Deeming
    • Section 3 SSI - Related Budgets for an Individual/Child
      • 3.1 Budget for SSI or State Supplement Payment
      • 3.2 Budget for Medicaid Coverage Under Pickle Amendment or Disabled Adult Child (DAC) or Disabled Widow(er) Disregards
      • 3.3 Budget for Categorically Needy Medicaid Coverage
      • 3.4 SSI, State Supplement and Categorically Needy budget for a child
    • Section 4 Budget for a Couple or an Eligible Individual with an Ineligible Spouse
      • 4.1 Budget for SSI or State Supplement Payment
      • 4.2 Budget for Medicaid for Coverage Under Pickle Amendment or   Disabled Adult Child (DAC) or Disabled Widow(er) (DWB) Disregards
      • 4.3 Budget for Categorically Needy Medicaid Coverage
    • Section 5 Katie Beckett Coverage
      • 5.1 Income and Assets
      • 5.2 Premiums
    • Section 6 Budgeting for Working Disabled
      • 6.1 Earnings
      • 6.2 Disability
      • 6.3 Changes
      • 6.4 Premiums
  • Part 8 Medicare Buy-In (Medicare Savings Program [MSP])[ Show/Hide] (Microsoft Word* or Adobe PDF*) --Last Revision January 2011
    • Section 1 Individuals Who Opted Out of Medicare
    • Section 2 Qualified Medicare Beneficiary (QMB)
    • Section 3 Specified Low Income Medicare Beneficiary  (SLMB)
    • Section 4 Qualifying Individual (QI)
    • Section 5 Qualified Disabled and Working Individual (QDWI)
  • Part 9 Special Groups – HIV/AIDS Waiver, Breast and Cervical, Non-Categorical [Show/Hide] (Microsoft Word* or Adobe PDF*)
    • Section 1 HIV/AIDS Waiver
      • 1.1 Basic Eligibility Requirements
        • 1.1.1 Medical Eligibility
        • 1.1.2 Financial Eligibility
      • 1.2 Income
      • 1.3 Assets
      • 1.4  Premiums
        • 1.4.1 Payment of Premiums
        • 1.4.2 Exemptions from Premium Payment
        • 1.4.3 Changes in Premium Amount
        • 1.4.4 Non-Payment of Premiums
      • 1.5 Administrative Hearings
      • 1.6 Wait List
    • Section 2 Breast and Cervical Cancer
    • Section 3 Non-Categorical Waiver
      • 3.1 Basic Eligibility Criteria
      • 3.2 Assets
      • 3.3 Income
      • 3.4 Budgeting
      • 3.5 Wait List
      • 3.6 Reinstatement Process
      • 3.7 Discontinuance of the Wait List
  • Part 10 Medically Needy Eligibility Criteria [ Show/Hide] (Microsoft Word* or Adobe PDF*)
    • Section 1 Medically Needy Asset Limits
    • Section 2 Medically Needy Income Limits
    • Section 3 Medically Needy Deductible Process
    • Section 4  Applicable Medical Costs
    • Section 5 Non-applicable Medical Costs
    • Section 6 Verification of Medical Costs
  • Part 11 State Supplement [Show/Hide] (Microsoft Word* or Adobe PDF*)
    • Section 1 Non-Financial Criteria
    • Section 2 Individuals Ineligible For SSI Due to the 8/96 Citizenship Rules
    • Section 3 Substantial Gainful Activity (SGA)
    • Section 4 Month of First Payment
    • Section 5 Types of Living Arrangements
    • Section 6 Changes in Living Arrangements
    • Section 7 SSI Closings
    • Section 8 Representative Payee
    • Section 9 Lost, Stolen, Destroyed, or Returned Checks
  • Part 12 Residential Care [Show/Hide] (Microsoft Word* or Adobe PDF*) --Last Revision August 2012
    • Section 1 Living Arrangements
    • Section 2 Coverable Groups
    • Section 3 Residential Care Asset Criteria
    • Section 4 Residential Care Income Criteria
      • 4.1 Adult Foster Homes (AFH)
      • 4.2 Flat Rate Boarding Homes (FRBH)
      • 4.3 Cost Reimbursement Boarding Homes (CRBH), Residential Care   Facilities (RCF) and Adult Family Care Homes (AFCH)
        • 4.3.1 Determining the Cost of Care for an Individual
        • 4.3.2 Determining the Cost of Care for a Couple
        • 4.3.3 Determining the Cost of Care for an Individual or Couple on SSI
        • 4.3.4 Changes in the Cost of Care
    • Section 5 Spousal Living Allowance
      • 5.1 Eligibility
      • 5.2 Benefits
  • Part 13 Home and Community Based Waiver [Show/Hide] (Microsoft Word* or Adobe PDF*) --Last Revision September 2011
    • Section 1 Definitions
    • Section 2 Coverable Groups
    • Section 3 Classification
    • Section 4 Waiver Assets
      • 4.1 Transfer of Assets
    • Section 5 Waiver Income
    • Section 6 Waiver Cost of Care
      • 6.1 Budgeting
  • Part 14 Individuals in Medical Institutions [ Show/Hide] (Microsoft Word* or Adobe PDF*) --Last Revision June 2012
    • Section 1 Institutionalized
      • 1.1 Special Income and Asset Limits
    • Section 2 Coverable Groups
    • Section 3 Medical Need Classification
      • 3.1 Individuals ineligible due to a transfer of assets
      • 3.2 Individuals who are not in need of nursing facility level of care
    • Section 4 Asset Criteria
      • 4.1  Long Term Care Partnership Plan
      • 4.2 Assets of Couples Residing in a Nursing Facility
      • 4.3 Assets of the Institutionalized Individual with a community spouse
      • 4.4 Hearing to Increase the Community Spouse Asset Allowance
      • 4.5 Transfer of Assets to the Community Spouse
      • 4.6 Non-Cooperation from the Community Spouse
    • Section 5 Income Criteria
      • 5.1 Income Ownership
      • 5.2 Income Limits
        • 5.2.1 Income Below the Categorical Limit
        • 5.2.2 Income Equal to or Above the Categorical Limit
    • Section 6 Cost of Care
      • 6.1 Determining the Individual’s Cost of Care
        • 6.1.1 Determining the Community Spouse Monthly Income Allocation
        • 6.1.2 Administrative Hearing Process for Income
        • 6.1.3 Dependent Allocation
        • 6.1.4 Calculating the Cost of Care for Individuals Below the Categorical Limit
        • 6.1.5 Calculating the Cost of Care for Individuals Equal to or Above the Categorical and Less than the Private Rate
      • 6.2 Changes in the cost of care
      • 6.3 Non-Covered Medical Expenses
      • 6.4 Lump Sums
      • 6.5 Medicare Buy-In for Institutionalized Individuals
  • Part 15 Transfer of Assets [Show/Hide] (Microsoft Word* or Adobe PDF*) --Last Revision August 2010
    • Section 1 Transfer of Assets for Institutionalized Individuals
      • 1.1 Definition of the look back period
      • 1.2 Definition of Individual
      • 1.3 Definition of Assets Subject to Transfer
      • 1.4 Exempt Transfers
      • 1.5 Fair Market Value
      • 1.6 Disproving the Presumed Transfer
      • 1.7 Establishing Date and Value of a Transfer
      • 1.8 Establishing a Penalty
      • 1.9 Hardship Waiver
  • Part 16 Assets [Show/Hide] (Microsoft Word* or Adobe PDF*)
    • Section 1 Use of Assets
    • Section 2 Treatment of Assets
      • 2.1 Agent Orange
      • 2.2 Alaskan Native Claims
      • 2.3 Annuities
      • 2.4 Assets being converted
      • 2.5 Bank accounts
      • 2.6 Burial Contracts/Spaces/Funds
      • 2.7 Certificates of Deposit
      • 2.8 Commercial Transportation Tickets
      • 2.9 Continuing Care Retirement Communities - Life Care Community
      • 2.10 Disaster Relief Act
      • 2.11 Disaster Unemployment Assistance
      • 2.12 Earned Income Tax Credit (EITC)
      • 2.13 Energy Assistance (Other than HEAP)
      • 2.14 Escrow Accounts
      • 2.15 Experimental Housing Allowance Payments
      • 2.16 Food Produced for Home Consumption
      • 2.17 Governor Baxter School for the Deaf Compensation
      • 2.18 Grants, Loans, and Scholarships
      • 2.19 Home Energy Assistance Program (HEAP)
      • 2.20 Household Goods
      • 2.21 Housing Act Assistance
      • 2.22 HUD community Development Block Grant
      • 2.23 Individual Development Accounts (IDA)
      • 2.24 Insurance Settlements
      • 2.25 JTPA and Job Corps
      • 2.26 Life Estate
      • 2.27 Life Insurance
      • 2.28 Life Lease (Tenancy)
      • 2.29 Loans
      • 2.30 Lump Sum Payments
      • 2.31 Native American Payments
      • 2.32 Nazi Persecution Payments
      • 2.33 Nutrition and Food Assistance
      • 2.34 Pension Plans (Individual and Employee)
      • 2.35 Promissory Notes and Mortgages
      • 2.36 Property used for home consumption
      • 2.37 Property used to produce income
      • 2.38 Radiation Exposure Compensation Act
      • 2.39 Real Property
      • 2.40 Relocation assistance
      • 2.41 Reparation Payments
      • 2.42 Replacement of an excluded asset
      • 2.43 Reverse Mortgage
      • 2.44 Ricky Ray Hemophilia Relief Fund Act
      • 2.45 Savings Bonds
      • 2.46 Savings Exclusion
      • 2.47 Self-Support Plans for Blind or Disabled Individuals
      • 2.48  Stepparent Assets
      • 2.49 Stocks, Bonds and Mutual Fund Shares
      • 2.50 Supplemental assistance
      • 2.51 Susan Walker Settlement
      • 2.52 Trusts
      • 2.53 Vehicles
      • 2.54 Veterans Payments for Vietnam Veterans’ natural children
      • 2.55 Volunteer Service Programs
  • Part 17 Income [Show/Hide] (Microsoft Word* or Adobe PDF*) --Last Revision January 2011
    • Section 1 Determination of Monthly Gross Income
    • Section 2 Garnishment of Income
    • Section 3 Types of Income
      • 3.1 Attributed Income
      • 3.2 Contract Income
      • 3.3 Earned Income
      • 3.4 Fluctuating Income
      • 3.5 Lump Sum Income
      • 3.6 Regular Income
      • 3.7 Seasonal Income
      • 3.8 Self-Employment Income
        • 3.8.1 Corporations
        • 3.8.2 Sole Proprietorship
        • 3.8.3 Partnership
      • 3.9 Unearned Income
    • Section 4 Treatment of Income
      • 4.1 Adoption Assistance
      • 4.2 Agent Orange Settlements
      • 4.3 ASPIRE Payments
      • 4.4 Burial Funds
      • 4.5 Cafeteria Plans
      • 4.6 Child Support
      • 4.7 Children Eligible for SSI - Related Coverage
      • 4.8 Children not Included in the Assistance Unit
      • 4.9 Combat Pay
      • 4.10 Commercial Transportation Tickets
      • 4.11 Compensated Work Therapy Program
      • 4.12 Cost of Living Adjustment (COLA)
        • 4.12.1 Cost of Living Adjustments taking effect January, February 4.12.2   Social Security and Rail Road Retirement VA Cost of Living Adjustments (COLA)
      • 4.13 Disability Insurance Payments
      • 4.14 Disabled Widowers Benefits
      • 4.15 Disaster Relief
      • 4.16 Disaster Unemployment Assistance
      • 4.17 Earned Income Exclusions for Blind or Disabled
      • 4.18 Earned Income Tax Credit (EITC)
      • 4.19 Emergency Assistance
      • 4.20 Emergency Conservation Services Program
      • 4.21 Experimental Housing Allowance Program
      • 4.22 FmHA Utility Reimbursement
      • 4.23 Food produced for personal consumption by members of the household
      • 4.24 Food Supplement Program
      • 4.25 Foster Care Payments
      • 4.26 General Assistance
      • 4.27 Goods and services
      • 4.28 Governor Baxter School Compensation
      • 4.29 Grants, Loans Scholarships
      • 4.30 Home Based Care Funds
      • 4.31 Home Energy Assistance Program (HEAP)
      • 4.32 Housing
      • 4.33 HUD Utility Reimbursement
      • 4.34 Individual Development Accounts
      • 4.35 Income of those who could be in the household except they are in a medical facility
      • 4.36 Income tax refunds
      • 4.37 Irregular or Infrequent Income
      • 4.38 Job Related Expenses
      • 4.39 JTPA/Job Corp Payments
      • 4.40 Loans
      • 4.41 Lump Sum Income
      • 4.42 Native American payments
      • 4.43 Nazi Persecution Payments
      • 4.44 Nutrition and Food Assistance
      • 4.45 Payments to replace income
      • 4.46 Radiation Exposure Compensation
      • 4.47 Rent rebates
      • 4.48 Repayment of a loan
      • 4.49 Ricky Ray Hemophilia Fund
      • 4.50 Savings bonds
      • 4.51 Self Support Plans
      • 4.52 Selling, replacing or exchanging an asset
      • 4.53 Senior Community Service Employment Program (SCSEP)
      • 4.54 SSI Payments
      • 4.55 Student Income
      • 4.56 Susan Walker Settlement
      • 4.57 TANF
      • 4.58 VA Benefits for Vietnam veterans’ children with spina bifida
      • 4.59 VA benefits have special treatment.
      • 4.60 Vendor Payments
      • 4.61 Volunteer Service Programs
      • 4.62 Combat Pay
  1. Appendices [Show/Hide] (Microsoft Word* or Adobe PDF*) --Last Revision June 2012
    1. Medicare and the Buy-In Process
    2. Calculations for Substantial Gainful Activities (SGA) and Impairment Related-  Work   Expenses (IRWE)
    3. Pickle Amendment
    4. Other Coverable Groups Still in Federal Law
    5. Life Estate and Remainder Interest Tables
    6. Consent Decision Form
    7. List of Supplies and Equipment Provided to Recipients in a Nursing Facility
    8. Transfers Taking Place Prior to 1/1/94 and Trusts Set Up Prior to 8/11/93
    9. Preparations for the Administrative Hearings Process
    10. Computation of the Standard Utility Allowance
  • Charts [ Show/Hide] (Microsoft Word* or Adobe PDF*) --Last Revision June 2012
    • Chart 1 Items Included in the Basic Cost Chart
    • Chart 2 Dependent Allocations Using AFDC-Related Income Limits
    • Chart 3 SSI - Related Standards, Allocations, and Disregards
      • 3.1 Disregards
      • 3.2 Maximum Allocations
      • 3.3 Maximum Income-in-Kind
      • 3.4 Maximum Countable Income
      • 3.5 Ineligible Spouse Standard
      • 3.6 SSI and State Supplement Maximum Income and Payment Amounts
      • 3.7  Annual QI2 Benefit - Removed
      • 3.8 Awaiting Placement for Residential Care (APRC)/Days Awaiting Placement
      • 3.9 Income Limit for Adult Family Care Homes
      • 3.10 Premiums for HIV Benefit - 7/01/07
      • 3.11 Spousal Living Allowance for SSI recipients
      • 3.12 Premiums for MaineCare Katie Beckett Coverage Group
    • Chart 4 Nursing Care Limits
      • Categorically Needy Nursing Care Status Income Limits
      • Maximum Waiver Allowances
      • Nursing Care Private Rate
      • Spousal Impoverishment
    • Chart 5 Protected Income Level (PIL)
    • Chart 6 Federal Poverty Levels (FPL)
    • Chart 7 Fee Schedule for QDWI
    • Chart 8 Cub Care

Chapter 333 - Low Cost Drugs for the Elderly and Disabled (DEL) [ Show/Hide] (Microsoft Word* or Adobe PDF*)

  • Section 1 Covered Indiviudals
    • 1.1 DEL and Medicare Part D
  • Section 2 Application Process
    • 2.1 Assets
    • 2.2 Income
  • Section 3 Continued Eligibility
  • Section 4 Notice of Eligibility
  • Section 5 Administrative Hearings
  • Section 6 Grandfathered Group

Chapter 334 - Maine Rx Plus [Show/Hide] (Microsoft Word* or Adobe PDF*)

  • Section 1 Covered Indiviudals
  • Section 2 Application Process
    • 2.1 Assets
    • 2.2 Income
  • Section 3 Continued Eligibility
  • Section 4 Notice of Eligibility
  • Section 5 Administrative Hearings

Chapter 335 - Health Insurance Purchase Option (HIPO) [ Show/Hide] (Microsoft Word* or Adobe PDF*) --Last Revision September 2010

  • Section 1 Eligibility Criteria
  • Section 2 Eligibility Period
  • Section 3 Notice of HIPO
  • Section 4 Application for Participation
  • Section 5 Premium Payment
  • Section 6 Notice of Termination & Right to a Hearing

Chapter 336 – Transfer of Asset Penalty for State-Funded Assistance in Residential Care [ Show/Hide] (Microsoft Word* or Adobe PDF*)

  • Section 1 Definition of the look back period
  • Section 2 Definition of Individual
  • Section 3 Definition of Assets Subject to Transfer
  • Section 4 Exempt Transfers
  • Section 5 Fair Market Value
  • Section 6 Disproving the Presumed Transfer
  • Section 7 Establishing Date and Value of Transfer
  • Section 8 Establishing a Penalty
  • Section 9 Hardship Waivers