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Library: Policy

317:35-7-44. Eligibility for TB related services

Revised 1-1-99

(a) An individual determined to be categorically related to disability because of TB is eligible for limited Medicaid benefits if he/she meets the conditions of eligibility shown in paragraphs (1)-(4) of this subsection.

  • (1) Must have verification of active TB infection from a medical practitioner;
  • (2) Countable income (earned and unearned) must be less than the categorically needy standards shown on DHS Appendix C-1, Schedule XIII. The income standard is based on the break-even point which is described in the Social Security Procedure/Operations Manual (POMS-SI 00810.350).
  • (3) Equity in capital resources cannot exceed the maximum allowable resources on DHS Appendix C-1, Schedule XIII., which is the allowable SSI resource standard for an individual.
  • (4) The individual meets all other eligibility conditions for Medicaid.

(b) Coverage is restricted to payment of TB related services with unlimited TB related drugs. Separate eligibility determinations are made for regular Medicaid and TB related services.

(c) Medical identification cards will be issued to all individuals determined eligible for TB related services.

(d) In cases where both members of a married couple or more than one member of a family are TB infected, each applicant shall be considered as a single individual and be subject to independent income and resource standards.   •1

(e) In cases where only one spouse is eligible or applies for TB related services, deeming can be done from the ineligible spouse's income in accordance with OAC 317:35-5-42(d)(6).   •2

  1. In this case no deeming can be done to minor dependent children.

  2. After deeming from the ineligible spouse's income, the remaining amount, when added to the eligible spouse's income, cannot exceed the amount on Appendix C-1, Schedule XIII.

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