441—92.1 (249A,249J) Definitions.
“Applicant” means an individual who applies for medical assistance under the IowaCare program described in this chapter.
“Clean claim” means a claim that can be adjudicated in the Medicaid claims payment system to result in either a paid or denied status.
“Department” means the Iowa department of human services.
“Dependent child” means the child or stepchild of an applicant or member who is living in the applicant’s or member’s home and is under the age of 18 or is 18 years of age and will graduate from high school or an equivalent level of vocational or technical school or training leading to a certificate or diploma before reaching the age of 19. Correspondence school is not an allowable program of study. “Dependent child” shall also include a child attending college or a school of higher learning beyond high school if the parents will claim the child as a dependent on their state or federal income tax return.
“Enrollment period” means the entire period that a member receives IowaCare without a break, which may include multiple certification periods.
“Federal poverty level” means the poverty income guidelines revised annually and published in the Federal Register by the U.S. Department of Health and Human Services.
“Group health insurance” means any plan of or contributed by an employer (including a self-insured plan) to provide health care (directly or otherwise) to the employer’s employees, former employees, or the families of the employees or former employees.
“Initial application” means the first application for IowaCare or an application that is filed after a break in assistance of one month or more.
“IowaCare” means the medical assistance program explained in this chapter.
“Medical expansion services” means the services described in Iowa Code Supplement section 249J.6.
“Member” means an individual who is receiving assistance under the IowaCare program described in this chapter.
“Newborn” means an infant born to a woman as defined in paragraph 92.2(1)“b.”