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Medicaid Eligibility Manual Eligibility Determinations

Issued March 01, 2024 Page 1 of H-1900 Replacing February 27, 2024 Revised/added text indicated by underscore Deleted text indicated by “**”

H-1900 TWELVE (12) MONTHS CONTINUOUS ELIGIBILITY

H-1910 TWELVE (12) MONTHS CONTINUOUS ELIGIBILTY FOR CHILDREN

Effective November 1, 1998, children under age 19 became eligible for continuous eligibility for 12 months from the point of the latest certification or renewal, regardless of changes in circumstances.

12 months continuous eligibility is applicable to all children under age 19 enrolled in Medicaid or LaCHIP with the following exceptions:

● Children who are eligible for the Spend-down Medically Needy Program;

● **

● Children whose parent/guardian fails to provide verification of citizenship or immigration status after a reasonable opportunity has been allowed.

The continuous eligibility period begins on the effective date of the child's most recent determination or redetermination of eligibility, and ends the last day of the 12 months.

A continuous eligibility period will end effective the earliest possible month if any of the following changes occur:

● The child reaches age 19.

● The child reaches the end of the 12 month continuous eligibility period.

● A written request for disenrollment from the child or child’s representative;

● The child no longer resides in the state;

● It is determined that eligibility was erroneously granted at the most recent determination of eligibility because of agency error or fraud, abuse, or perjury attributed to the child or the child's representative.

● The child dies