R414-320-4. General Eligibility Requirements

  (1) The provisions of Sections R414-302-3, R414-302-4, R414-302-7, and R414-302-8 concerning United States (U.S.) citizenship, alien status, state residency, use of social security numbers, and applying for other benefits, apply to adult applicants and enrollees of UPP.

  (2) The provisions of Sections R382-10-6, R382-10-7, and R382-10-9 concerning U.S. citizenship, alien status, state residency and social security numbers apply to child applicants and enrollees.

  (3) An individual who is not a U.S. citizen or national, or who does not meet the alien status requirements of Sections R414-302-3 or R382-10-6 is not eligible for any services or benefits under the UPP program.

  (4) Health plans must meet the criteria of being an UPP qualified health plan.

  (5) An individual must apply for the UPP program before he turns 65 years of age. Enrollment shall end effective the end of the month in which an individual turns 65 years of age.

  (6) The eligibility agency only accepts applications during open enrollment periods. The eligibility agency may limit the number of individuals it enrolls.

  (a) The eligibility agency may stop enrollment of new individuals at any time.

  (b) The open enrollment period may be limited to:

  (i) adults with children living in the home;

  (ii) adults without children living in the home, or;

  (iii) other groups designated in advance by the eligibility agency consistent with efficient administration of the program.

  (c) The eligibility agency may not accept applications or maintain waiting lists during a period that it stops enrollment of new individuals.

  (d) A child is not subject to the open enrollment requirement to enroll in UPP.

  (7) Residents of public institutions are not eligible for UPP.

  (a) A child under the age of 18 is not a resident of an institution if the child is living temporarily in the institution while arrangements are being made for other placement.

  (b) A child who resides in a temporary shelter for a limited period of time is not a resident of an institution.

  (8) The eligibility agency may not require an applicant or enrollee for the UPP program to provide Duty of Support information. An adult whose eligibility for Medicaid has been denied or terminated for failure to cooperate with Duty of Support requirements may not enroll in the UPP program.