SECTION 317:35-6-37. Financial eligibility of categorically needy individuals related to AFDC or pregnancy-related services

  Individuals whose income is less than the SoonerCare Income Guidelines for the applicable eligibility group are financially eligible for SoonerCare.

(1)   Categorically related to pregnancy-related services. For an individual related to pregnancy-related services to be financially eligible, the countable income must be less than the appropriate standard according to the family size on the SoonerCare Income Guidelines. In determining the household size, the pregnant woman and her unborn child(ren) are included.

(2)   Categorically related to children's and parent/caretakers' groups.

(A)   Parent/caretakers' group. For the individual in the parent/caretakers' group to be considered categorically needy, the SoonerCare Income Guidelines must be used.

(i)   SoonerCare Income Guidelines. Individuals age 19 years or older, other than pregnant women, are determined categorically needy if countable income is less than the Categorically Needy Standard, according to the family size.

(ii)   SoonerCare Income Guidelines. All individuals under 19 years of age are determined categorically needy if countable income is equal to or less than the Categorically Needy Standard, according to the size of the family.

(B)   Families with children. Individuals who meet financial eligibility criteria for the children's and parent/caretakers' groups are:

(i)   All persons included in an active TANF case.

(ii)   Individuals related to the children's or parent/caretakers' groups whose countable income is within the current appropriate income standard, but who do not receive TANF assistance.

(iii)   All persons in a TANF case in Work Supplementation status who meet TANF eligibility conditions other than earned income.

(iv)   Those individuals who continue to be eligible for Medicaid in a TANF case after they become ineligible for a TANF payment. These individuals will continue to be considered categorically needy if the TANF case was closed due to child or spousal support, the loss or reduction of earned income exemption by any member of the assistance unit, or the new or increased earnings of the caretaker relative.

[Source: Added at 16 Ok Reg 708, eff 1-1-99 (emergency); Added at 16 Ok Reg 1438, eff 5-27-99; Amended at 19 Ok Reg 136, eff 9-1-01 (emergency); Amended at 19 Ok Reg 2149, eff 6-27-02; Amended at 30 Ok Reg 1209, eff 7-1-13; Amended at 31 Ok Reg 73, eff 9-24-13 (emergency); Amended at 31 Ok Reg 1720, eff 9-12-14; Amended at 33 Ok Reg 903, eff 9-1-16]