1. (a) All recipients shall be subject to service limits in accordance with He-W 530.03.

2. (b) All recipients shall be subject to the co-payments specified in He-W 530.04, except for:

   1. (1) Recipients with income at or below 100% of the federal poverty level (FPL);
   2. (2) Recipients residing in a nursing facility, hospital, intermediate care facility for individuals with intellectual disabilities, or other medical institution;
   3. (3) Recipients participating in the home and community based care (HCBC) waiver programs;
   4. (4) Recipients receiving services that relate to pregnancy, in accordance with 42 CFR 447.53(b)(2), or any other medical condition that might complicate the pregnancy;
   5. (5) Recipients under the age of 18;
   6. (6) Women eligible through the Breast and Cervical Cancer Treatment Program, pursuant to 42 CFR 435.213;
   7. (7) Recipients receiving hospice care pursuant to He-W 544; and
   8. (8) Individuals who are members of a federally recognized Indian tribe or Alaskan natives who have ever been served through the Indian Health Services Programs, pursuant to 42 CFR 447.56(a)(x).
3. (c) All recipients shall be subject to non-covered services provisions in accordance with He-W 530.05.

Source. (See Revision Note at chapter heading He-W 500); ss by #4863, eff 7-12-90, EXPIRED: 7-12-96 New. #6745, eff 5-1-98, EXPIRED: 12-31-98; ss by #6925, eff 1-1-99; ss by #8780, INTERIM, eff 1-1-07, EXPIRES: 6-30-07; ss by #8929, eff 6-30-07; amd by #10016, eff 11-1-11; amd by #10716, eff 11-18-14; ss by #10915, eff 8-26-15; ss by #11101, eff 5-25-16