Page 58

Title 8: Medicaid Page 54 Iowa Department of Health and Human Services Employees’ Manual Chapter F: Coverage Groups MAGI-Related Coverage Groups Revised February 28, 2025 Mothers and Children (MAC) Program

1. The Food Assistance household includes Ms. B and her two children, Ashley (age 8) and Carly (age 5), and Ms. B’s mother, Mrs. R. The children have never been on Medicaid and have not had their reasonable period of opportunity to verify citizenship and identity. The household applies for Food Assistance and is approved effective October 15. Both children meet express-lane eligibility for the MAC group, except for proof of citizenship and identity. The family is issued:  Form 470-4851, Express Lane Medicaid for Children (listing both children), and  Form 470-2826, Insurance Questionnaire. Ms. B provides form 470-4851 to the local office within the 30-day period and requests MAC for both children. The IM worker codes ELIAS to approve Medicaid under Express Lane” for each child. The children are approved for MAC eligibility beginning October 1 (the first day of the month that the Food Assistance began). The ELIAS system automatically initiates a request for proof of citizenship and identity when the children are approved for Medicaid. See 8-C, Documentation Process, for more information. If the children have unpaid medical bills for July, August, or September, retroactive Medicaid can be considered. However, eligibility for Medicaid in the retroactive months must be determined using standard Medicaid guidelines for all eligibility factors (e.g., citizenship proof, income, eligible group, category of eligibility for the retroactive period as defined in 8-A, Definitions, etc.). 2. Same as Example 1, but both girls have previously had their period of reasonable opportunity and did not provide proof of citizenship and identity at that time. When form 470-4851 is issued, a request for proof of citizenship and identity is also sent. Mrs. B returns form 470-4851 to request MAC for both children. She provides citizenship and identity verification for Ashley but not for Carly. The IM worker codes ELIAS to approve Medicaid under Express Lane” only for Ashley when she approves her for MAC. The IM worker cannot approve Carly for Medicaid without proof of citizenship and identity because Carly has already used her reasonable period of opportunity. The Notice of Action will show that only Ashley is approved for MAC.