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another case was the child's sibling and mother. When the certificate is requested, the mother and her 2 children are now living together. Unless there is a reason to issue separate certificates as requested by the family, or because there are too many eligibility periods, one certificate using all 3 recipients and their Medicaid coverage periods should be issued.

6. Enter the recipient's Medicaid number, i.e., the RID, not the case number.

7. List all creditable coverage periods after July 1, 1996, up to the present time without regard to category changes. For example, if a child were on MA 2 from 1/1/97 to 6/30/97 and MA D from 7/1/97 to 9/30/97, the entry on the certificate would be BEGIN 1/1/97 END 9/30/97

The statement on the Certificate which states that prior breaks in coverage may be included is information for health insurance companies only. The law specifies that certain coverage that has been interrupted cannot count as creditable coverage. The insurance company determines how creditable coverage is applied to an exclusionary period and the statement on the Certificate is simply to alert them to the fact that all coverage periods, regardless of breaks, are being reported on the form. The following is an example of how to enter eligibility periods on a Certificate:

Example: Recipient was eligible from 10/96 through 11/97 with a spend-down. He met his spend-down in the months of 10/96, 12/96, 3/97, and 10/97. Entries on the Certificate should be listed as follows: BEGIN END 10/02/96 10/31/96 12/05/96 12/31/96 03/10/97 03/31/97 10/01/97 10/31/97 (Months that the spend-down is not met are not listed, and the DFR should inquire of HP what months spend-down was/was not met.)

2238.20.00 CONTINUOUS ELIGIBILITY FOR CHILDREN UNDER AGE 19

Effective 1/1/24, children under the age of 19 who are determined or redetermined eligible for any category of Medicaid will remain continuously eligible until their next annual redetermination. Medicaid coverage is to be retained for a full 12 months regardless of income or other factors that would otherwise cause the child to be discontinued. The continuous eligibility period (CE) and/or category is established or reestablished by the effective date of the member’s application decision or annual redetermination decision (can include retro coverage); whichever is most recent.7 Where CE and TMA both exist for a child; they should receive the longest possible protected period based on whether the TMA or the CE ends first.” Category changes from full (Package A, Medicaid or HHW) to limited (Package C, MA 10) benefits are not allowed, and closure should only happen for these reasons:

• Death • Moved out of State • Voluntary withdrawal (See 2250.00.00 for written/verbal voluntary withdrawal policies).