1. (1) The following individuals are not eligible for Adult Expansion Medicaid:

   1. (a) with the exception of the Targeted Adult Medicaid program, individuals eligible for other Medicaid programs without a spenddown; or
   2. (b) individuals eligible for or receiving Medicare.

2. (2) An individual must be at least 19 years old and not yet 65 years old to enroll in Adult Expansion Medicaid.

   1. (a) The month in which an individual turns 19 years old is the first month in which the individual may enroll in Adult Expansion Medicaid.
   2. (b) An individual may only enroll in Adult Expansion Medicaid through the month in which the individual turns 65 years old.
3. (3) Eligibility for Adult Expansion Medicaid does not require a resource test.
4. (4) A member is required as a condition of eligibility, to enroll or remain enrolled in a qualified health insurance plan offered by the member's employer.

Unless otherwise stated, the provisions in Rule R414-302 and Section R414-306-4 apply to all applicants and enrollees.

KEY: Medicaid, adult expansion, eligibility

Date of Last Change: July 2, 2025

Notice of Continuation: August 12, 2024

Authorizing, and Implemented or Interpreted Law: 26B-3-108; 26B-1-213