Md. Code Regs. 14.35.07.07

Current through Register Vol. 51, No. 24, December 2, 2024

Section 14.35.07.07 - General Eligibility Requirements-Residency in Individual Exchange Service Area

A. For the purpose of determining eligibility for enrollment in a QHP under Regulation .05(A)(2) of this chapter, an individual shall be considered a resident of the Exchange service area if:

(1) An individual is 21 years old or older, is not living in an institution, is capable of indicating intent, and is not receiving an optional State supplementary payment and the individual lives in the Individual Exchange service area, including without a fixed address; or

(2) An individual is younger than 21 years old, is not living in an institution, is not eligible for Medicaid based on receipt of assistance under Title IV-E of the Social Security Act, is not emancipated, is not receiving an optional State supplementary payment, and the individual either:

(a) Resides in the Exchange service area, including without a fixed address; or

(b) Resides with a parent or caretaker who resides in the service area of the Individual Exchange under §A(1) of this regulation.

B. For individuals not described in §A of this regulation, an individual shall be considered a resident of the Individual Exchange service area if the individual meets the State residency requirements set forth in COMAR 10.09.24.05-3.

C. If members of the tax household are not residents of the same Individual Exchange service area, the tax household may indicate any Individual Exchange service area for which one of the tax filers meets the regulation as the tax household's residency.

D. If both spouses in a tax household enroll in a QHP through the same Individual Exchange, a tax dependent may only enroll in a QHP through the Individual Exchange, or through a different health benefit exchange for which the dependent meets the residency standard.

E. The Individual Exchange may not deny or terminate an individual's eligibility for enrollment in a QHP through the Individual Exchange if the individual meets the residency standard under this regulation but for a temporary absence from the service area of the Individual Exchange and the individual intends to return when the purpose of the absence has been accomplished.

F. The service area of the Individual Exchange is Maryland.

Md. Code Regs. 14.35.07.07

Regulation .07 adopted effective 46:5 Md. R. 306, eff. 3/11/2019