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37.86.5103    PASSPORT TO HEALTH PROGRAM: ELIGIBILITY

(1) The department may require a medicaid recipient in any of the following medicaid eligibility groups to enroll and participate in the passport to health program, unless exempted from or ineligible for participation as defined by ARM 37.86.5102(8) or (9) :

(a) families achieving independence in Montana (FAIM) ;

(b) supplemental security income (SSI) ; or

(c) SSI-related.

(2) A medicaid recipient is exempt from or is not allowed to participate in passport to health if the recipient:

(a) is exempted by the department from participation because of hardship; or

(b) is enrolled in a health maintenance organization (HMO) .

(3) A non-pregnant, medicaid recipient 21 years of age or older and eligible for medicaid as a participant in the TANF welfare demonstration project as required at ARM 37.78.101, et seq., must enroll in an HMO unless an HMO is not available or the available HMOs are at capacity.

(4) At the department's discretion, medicaid recipients who are exempted from participation, as defined in ARM 37.86.5102(8) , may elect to enroll in a passport to health program by choosing a primary care provider from a county that the program serves, unless the recipient is ineligible.

History: Sec. 53-2-201 and 53-6-113, MCA; IMP, Sec. 53-6-113, 53-6-116 and 53-6-117, MCA; NEW, 1992 MAR p. 2288, Eff. 10/16/92; AMD, 1994 MAR p. 2983, Eff. 11/11/94; AMD, 1996 MAR p. 284, Eff. 1/26/96; AMD, 1996 MAR p. 2193, Eff. 8/9/96; AMD, 1997 MAR p. 2085, Eff. 11/18/97; TRANS, from SRS, 2000 MAR p. 481; AMD, 2000 MAR p. 866, Eff. 3/31/00; AMD, 2004 MAR p. 1624, Eff. 7/23/04.

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