5101.5212 Qualifications for medical assistance under buy-in program.
(A) Under the children’s buy-in program and subject to section 5101.5213 of the Revised Code, an individual who does both of the following in accordance with rules adopted under section 5101.5215 of the Revised Code qualifies for medical assistance under the program, unless the director of job and family services has adopted rules under division (B) of section 5101.5215 of the Revised Code to limit the number of individuals who may participate in the program at one time and the program is serving the maximum number of individuals specified in the rules:
(1) Applies for the children’s buy-in program;
(2) Provides satisfactory evidence of all of the following:
(a) That the individual is under nineteen years of age;
(b) That the individual’s countable family income exceeds three hundred per cent of the federal poverty guidelines;
(c) Except as provided in division (B) of this section, that the individual has not had creditable coverage for at least three months before enrolling in the children’s buy-in program. (d) That the individual meets the additional eligibility requirements for the children’s buy-in program established in rules adopted under section 5101.5215 of the Revised Code.
(B) Division (A)(2)(c) of this section does not apply to an individual who meets both of the following requirements:
(1)At least one of the following applies to the individual:
(a)The individual’s parents are involuntarily unemployed.
(b)At least one of the individual’s parents is unable to find work due to a disabling condition.
(c)At least one of the individual’s parents involuntarily lost creditable coverage for the individual.
(d)The individual has creditable coverage under COBRA continuation coverage as defined in 42 U.S.C. 1396a(u)(3).
(2)At least one of the following applies to the individual:
(a)The cost of the least expensive creditable coverage available to the individual is greater than ten per cent of the individual’s countable family income.
(b)The premium for the creditable coverage with the lowest premium available to the individual is greater than one hundred fifty per cent of the premium applicable to the individual under the children’s buy-in program.
(c) The individual is unable to obtain creditable coverage due to a pre-existing condition of the individual.
(d) The individual lost the only creditable coverage available to the individual because the individual has exhausted a lifetime benefit limitation.
(e) The individual participates in the program for medically handicapped children.
Amended by 128th General Assembly File No. 9, HB 1, § 101.01, eff. 10/16/2009.
5101.5212 Qualifications for medical assistance under buy-in program.
(A) Under the children’s buy-in program and subject to section 5101.5213 of the Revised Code, an individual who does both of the following in accordance with rules adopted under section 5101.5215 of the Revised Code qualifies for medical assistance under the program, unless the director of job and family services has adopted rules under division (B) of section 5101.5215 of the Revised Code to limit the number of individuals who may participate in the program at one time and the program is serving the maximum number of individuals specified in the rules:
(1) Applies for the children’s buy-in program;
(2) Provides satisfactory evidence of all of the following:
(a) That the individual is under nineteen years of age;
(b) That the individual’s countable family income exceeds three hundred per cent of the federal poverty guidelines;
(c) Except as provided in division (B) of this section, that the individual has not had creditable coverage for at least three months before enrolling in the children’s buy-in program. (d) That the individual meets the additional eligibility requirements for the children’s buy-in program established in rules adopted under section 5101.5215 of the Revised Code.
(B) Division (A)(2)(c) of this section does not apply to an individual who meets both of the following requirements:
(1)At least one of the following applies to the individual:
(a)The individual’s parents are involuntarily unemployed.
(b)At least one of the individual’s parents is unable to find work due to a disabling condition.
(c)At least one of the individual’s parents involuntarily lost creditable coverage for the individual.
(d)The individual has creditable coverage under COBRA continuation coverage as defined in 42 U.S.C. 1396a(u)(3).
(2)At least one of the following applies to the individual:
(a)The cost of the least expensive creditable coverage available to the individual is greater than ten per cent of the individual’s countable family income.
(b)The premium for the creditable coverage with the lowest premium available to the individual is greater than one hundred fifty per cent of the premium applicable to the individual under the children’s buy-in program.
(c) The individual is unable to obtain creditable coverage due to a pre-existing condition of the individual.
(d) The individual lost the only creditable coverage available to the individual because the individual has exhausted a lifetime benefit limitation.
(e) The individual participates in the program for medically handicapped children.
Amended by 128th General Assembly File No. 9, HB 1, § 101.01, eff. 10/16/2009.
5101.5212 Qualifications for medical assistance under buy-in program.
(A) Under the children’s buy-in program and subject to section 5101.5213 of the Revised Code, an individual who does both of the following in accordance with rules adopted under section 5101.5215 of the Revised Code qualifies for medical assistance under the program, unless the director of job and family services has adopted rules under division (B) of section 5101.5215 of the Revised Code to limit the number of individuals who may participate in the program at one time and the program is serving the maximum number of individuals specified in the rules:
(1) Applies for the children’s buy-in program;
(2) Provides satisfactory evidence of all of the following:
(a) That the individual is under nineteen years of age;
(b) That the individual’s countable family income exceeds three hundred per cent of the federal poverty guidelines;
(c) Except as provided in division (B) of this section, that the individual has not had creditable coverage for at least three months before enrolling in the children’s buy-in program. (d) That the individual meets the additional eligibility requirements for the children’s buy-in program established in rules adopted under section 5101.5215 of the Revised Code.
(B) Division (A)(2)(c) of this section does not apply to an individual who meets both of the following requirements:
(1)At least one of the following applies to the individual:
(a)The individual’s parents are involuntarily unemployed.
(b)At least one of the individual’s parents is unable to find work due to a disabling condition.
(c)At least one of the individual’s parents involuntarily lost creditable coverage for the individual.
(d)The individual has creditable coverage under COBRA continuation coverage as defined in 42 U.S.C. 1396a(u)(3).
(2)At least one of the following applies to the individual:
(a)The cost of the least expensive creditable coverage available to the individual is greater than ten per cent of the individual’s countable family income.
(b)The premium for the creditable coverage with the lowest premium available to the individual is greater than one hundred fifty per cent of the premium applicable to the individual under the children’s buy-in program.
(c) The individual is unable to obtain creditable coverage due to a pre-existing condition of the individual.
(d) The individual lost the only creditable coverage available to the individual because the individual has exhausted a lifetime benefit limitation.
(e) The individual participates in the program for medically handicapped children.
Amended by 128th General Assembly File No. 9, HB 1, § 101.01, eff. 10/16/2009.
