Basic Considerations

The following basic eligibility requirements must be met to qualify:

Age. The applicant’s statement of the child’s date of birth may be acceptable. Refer to Section 2255 - Age (Family Medicaid) .

Enumeration. Refer to Section 2220 - Enumeration . Enumeration is not a requirement for Emergency Medical assistance (EMA). Refer to Section 2054 - Emergency Medical Assistance .

Citizenship/Immigration/Identity. Refer to Section 2215 - Citizenship/Immigration/Identity .

Residency. Refer to Section 2225 - Residency .

Third Party Liability (TPL). Refer to Section 2230 - Third Party Liability .

This includes TPL information on the reputed or legal father of an existing child.

Cooperation with the Division of Child Support Services (DCSS). Refer to Section 2250 - Cooperation with Division of Child Support Services .

A referral to and cooperation with DCSS is NOT a requirement for child-only Medicaid cases. A child-only Medicaid case is defined as a Medicaid AU in which no adults are receiving Medicaid under the child’s case or under any related case. An AU that contains a penalized adult is NOT considered a child-only case.

Resources are not considered in determining eligibility.