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MEDICAL SERVICES POLICY MANUAL,SECTION I I-200 Families and Individuals (MAGI) Groups Renewal Process

I 230 Newborns Renew inARKids First

1. Ensure that the completed renewal form and any verification provided by the individual is scanned into the system upon receipt; 2. Review the information provided and request any necessary verification to validate the information; and 3. If validated, enter any new or changed information to the system and trigger a new eligibility determination within the system. The system will then generate appropriate notices to the individual and take action to continue Medicaid coverage or terminate it if eligibility no longer exists.

I-230 Newborns Renew in ARKids First MS Manual 01/01/14 Newborn coverage ends the last day of the month of the child’s first birthday. Prior to that date, an ARKids First eligibility determination using the ex parte renewal process described in MS I-210 will be attempted based on information already known about the newborn’s household composition and income. If sufficient information is not available to determine the newborn’s ARKids First eligibility, then a pre-populated form as described in MS I-220 will be sent to the newborn’s parent or caretaker adult for completion. Upon the form’s return, eligibility for either ARKids A or B will be determined and if eligible, the newborn will be enrolled in the appropriate ARKids group. If not eligible due to household income, then an Account Transfer will be made to the FFM for an eligibility determination for Advanced Premium Tax Credits (APTCs) and selection of a Qualified Health Plan (QHP). The ARKids eligibility determination must be completed prior to the first day of the newborn’s birth month to ensure the newborn can have uninterrupted coverage either through ARKids or enrollment in a QHP.