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resemble the one used by the Healthy Families Program. Applications are processed and an eligibility determination made within thirty (30) days. Medi-Cal Eligibility will be established and enrollment continued in a manner that is consistent with the state’s Title XIX plan. ACCESS FOR INFANTS AND MOTHERS (AIM) PROGRAM Families fill out a four-page application and mail it, with accompanying supporting documents, to MRMIB’s administrative vendor. Applications are available in English and Spanish. The supporting documents families send include documentation of income which the administrative vendor verifies using copies of the past year’s federal income tax forms, or current year wage stubs. MAXIMUS reviews the application within a 10 day time frame and either requests additional information from the applicant or enrolls the pregnant woman in the purchasing pool health plan selected by the woman. Coverage under the purchasing pool plan begins 10 days after the application has been determined complete. Eligibility is determined once -- at time of application to the program-- and continues for 60 days post partum, for the mother and up to the child’s second birthday for children born to mothers enrolled in the AIM Program prior to July 1, 2004. For children born to mothers enrolled on or after July 1, 2004 eligibility is determined at the time of the mother’s application to the AIM Program and again before the child’s first birthday and annually thereafter. Upon notification of birth, the infant will be enrolled in the Healthy Families Program. Prior to the child’s first birthday, the Healthy Families Program will conduct an annual redetermination for the child’s second year of coverage. Prior to the child’s second birthday, the Healthy Families Program will redetermine eligibility for the S-CHIP Healthy Families Program. The state seeks FFP for the health care costs of the child up to age two for children with family incomes between 200% and 300% of poverty. 4.3.1. Describe the state’s policies governing enrollment caps and waiting lists (if any). (Section 2106(b)(7)) (42CFR 457.305(b)) Check here if this section does not apply to your state. Effective Date: Approval Date: November 1, 2009 HFP Family Contribution Increase November 1, 2009 HFP Co-Payment Increase November 1, 2009 HFP Limited Dental Plan Choice for New Subscribers

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