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Title 8: Medicaid Page 14 Iowa Department of Health and Human Services Employees’ Manual Chapter F: Coverage Groups Pregnant or Postpartum Women and... Revised February 28, 2025 Deemed Newborn Children of Medicaid…

Ms. G, age 19, receives Medicaid as an SSI recipient. On April 10, she reports the birth of her child on April 2. The child is not added to Ms. G’s SSI case. A MAC case is opened up for the infant because the deemed newborn is a child of a Medicaid-eligible mother. On May 3, Ms. G reports she is moving to Illinois. The worker cancels her assistance June 1. Ms. G applies for and receives Medicaid in Illinois for the month of June. On July 4, Ms. G returns to Iowa. Even though Ms. G has continuously received Medicaid, and her child is under one year of age, Ms. G must file an application and meet all program requirements if she wishes to receive Medicaid for the child. Her child is no longer eligible for the deemed newborn coverage group. Coverage of a deemed newborn child under another coverage group in Iowa does not preclude the child from attaining or reattaining deemed newborn eligibility within the one-year period. When the Deemed Newborn Reaches Age One Legal reference: 441 IAC 75 (Rules in Process) Policy: A child who has remained eligible because of deemed newborn status during the first year must be found eligible for Medicaid under another coverage group to continue Medicaid eligibility past the child’s first birthday. Eligibility under the deemed newborn status ends on the last day of the month in which the child in deemed newborn status turns age one. An application or review form is not required. If additional information is needed in order to complete a redetermination, request this information in writing before the month of the first birthday. NOTE: System-generated review forms will not be issued when the only active person on the case is in deemed newborn status.

Ms. K, age 17, receives Medicaid under MAC. Her child is eligible for Medicaid as a deemed newborn child of a Medicaid-eligible mother. This child turns one on June 4. In June, the system completes an automatic redetermination. Eligibility is redetermined to MAC for the child and MAC eligibility continues for Ms. K.