Procedures

Screen for Parent/Caretaker with Child(ren) Medicaid. If the applicant is eligible, approve. If not, proceed with the Children Under 19 Years of Age Medicaid.

Follow the steps below to determine eligibility for a child:

Step 1 Review the application and contact the applicant by telephone or mail if additional information is needed that is not included in the application. If no additional information is needed, proceed with processing the application. Step 2 Determine the AU and BG. Refer to Chapter 2600 - Family Medicaid Assistance Units and Budget Groups . Step 3 Establish all points of eligibility. Accept the A/R’s statement unless information known to the agency conflicts with the A/R’s statement or is otherwise questionable. Step 4 Based on tax filer or non-tax filer status, apply the appropriate FPL depending on the BG size, to determine eligibility for the child(ren). Refer to Section 2245 - Living With A Specified Relative/Tax Filer/ Non-Tax Filer Status . Refer to Appendix A2 - Financial Limits for Family Medicaid TOC . Step 5 Verify all MAGI income of the BG. Refer to Section 2051 - Verification . Step 6 Complete the budgeting process. Refer to Section 2669 - MAGI Budgeting . Step 7 Refer any AU with a child under the age of 5 to WIC. Section Section 2985 - Women, Infants and Children (WIC) Services . Step 8 If eligible, approve.

If any child is ineligible, complete and document the results of a Continued Medicaid Determination (CMD) for the ineligible child(ren) prior to denial. Refer to Section 2052 - Continuing Medicaid Determination .

When eligibility is denied/closed because the MAGI income is above the Medicaid income limit, but at or below the PeachCare for Kids® income limit, a system CMD will be completed to PeachCare for Kids®.

When the MAGI income limit is above the PeachCare for Kids® income limit a system CMD will be completed to GA Access.