Section 45.3 - Eligibility criteria

45.3 Eligibility criteria.

(a) To be eligible for medical care reimbursement for cystic fibrosis and/or medical insurance premium payment through this program, such individual:

(1) shall be at least 21 years old;

(2) shall have been diagnosed as having cystic fibrosis;

(3) shall have resided in New York State for a minimum of 12 continuous months immediately prior to application for services from the Adult Cystic Fibrosis Assistance Program;

(4) shall not be eligible for medical benefits under any group or individual health insurance policy;

(5) shall not be eligible for medical assistance (Medicaid) pursuant to title 11 of article five of the Social Services Law solely due to earned income;

(6) shall submit an application and provide such other information, including documentation of net annual income, as required by the commissioner; and

(7) shall pay annually seven percent of his or her net annual income toward the cost of medical care related to cystic fibrosis and/or the cost of annual health insurance premiums at such intervals as are agreed upon by an authorized representative of the commissioner.

(b) To be a partially eligible individual for whom medical care reimbursement for cystic fibrosis and/or medical insurance premium payment will be provided through this program on a supplemental basis, such individual shall meet all criteria of a fully eligible individual except that a partially eligible individual shall have medical care reimbursement benefits available under a group or individual health insurance policy which does not provide full coverage for the care and treatment of cystic fibrosis.
 

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