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Other individuals are mandatorily included for budgeting purposes, based on the household composition and income/asset rules for the category of the individual whose eligibility is being determined.

When adding an individual to the case, Medicaid benefits should not be selected for any new individual who does not already have Medicaid unless they have submitted an application.

The only exceptions are:

• A baby born to a mother who was eligible and enrolled for Medicaid on the date of the child’s birth should be opened in MA X without requiring an application for the baby • Individuals who are verified by the Social Security Administration interface (SDX) as SSI recipients, who are not already receiving Medicaid, should be opened into MASI coverage (this usually happens systematically without requiring action by a worker) • Children who previously had MA 4 or MA 8 and are being transferred from the Department of Child Services to be determined for other Medicaid eligibility due to a change in ward/foster/adoption assistance status.

Note: An individual who has applied for or is receiving a Medicare Savings Program benefit may request to also be considered for full coverage Medicaid. This request does not have to be in writing; however, this should be limited to actual member or Authorized Representative request because there may be additional Estate Recovery considerations when changing/adding full coverage to MSP. (See 4705.00.00 for more information on Estate Recovery).

All relevant information for the individual/s being added to the case should be entered on the appropriate screens, and if additional information is needed to determine eligibility for any AG where the new individual’s income/assets will count is needed, a request for information should be sent.

2225.10.00 ADDING A NEWBORN CHILD

An infant born alive to an individual enrolled in any MA category except MA10 is deemed eligible for Medicaid without an application for the infant being submitted. The baby is to be immediately added to IEDSS upon the agency receiving notification of the birth. Refer to Section 2428.00 for more information regarding eligibility in the Newborn category.

Health coverage under the Newborn category is effective the first day of the month in which the child is born and continues for 12 consecutive months. The only allowable reasons to discontinue MA before the end of the 12-month Newborn period are:

• The child no longer lives in Indiana • The child’s parent or caretaker provides a written voluntary withdrawal statement, or